Abstract

BackgroundHepatocellular carcinoma (HCC) is a highly heterogeneous disease, which makes the prognostic prediction challenging. As part of the active cross-talk between the tumor and the host, inflammatory response in the tumor or its microenvironment could affect prognosis. However, the prognostic value of inflammatory response-related genes in HCC remains to be further elucidated.MethodsIn this study, the mRNA expression profiles and corresponding clinical data of HCC patients were downloaded from the public database. The least absolute shrinkage and selection operator Cox analysis was utilized to construct a multigene prognostic signature in the TCGA cohort. HCC patients from the ICGC cohort were used for validation. Kaplan Meier analysis was used to compare the overall survival (OS) between high- and low-risk groups. Univariate and multivariate Cox analyses were applied to determine the independent predictors for OS. Single-sample gene set enrichment analysis was utilized to calculate the immune cell infiltration score and immune related pathway activity. Gene set enrichment analysis was implemented to conduct GO terms and KEGG pathways. The qRT-PCR and immunohistochemistry were utilized to perform the mRNA and protein expression of prognostic genes between HCC tissues and normal liver tissues respectively.ResultsAn inflammatory response-related gene signature model was constructed by LASSO Cox regression analysis. Compared with the low-risk group, patients in the high-risk group showed significantly reduced OS. Receiver operating characteristic curve analysis confirmed the predictive capacity of the prognostic gene signature. Multivariate Cox analysis revealed that the risk score was an independent predictor for OS. Functional analysis indicated that immune status was definitely different between two risk groups, and cancer-related pathways were enriched in high-risk group. The risk score was significantly correlated with tumor grade, tumor stage and immune infiltrate types. The expression levels of prognostic genes were significantly correlated with sensitivity of cancer cells to anti-tumor drugs. Furthermore, the expression of prognostic genes showed significant difference between HCC tissues and adjacent non-tumorous tissues in the separate sample cohort.ConclusionA novel signature constructed with eight inflammatory response-related genes can be used for prognostic prediction and impact the immune status in HCC. Moreover, inhibition of these genes may be a therapeutic alternative.

Highlights

  • Liver cancer is the sixth most commonly diagnosed cancer and the fourth leading cause of cancer death worldwide [1]

  • Since stromal cells were the important components of the tumor microenvironment, especially in Hepatocellular carcinoma (HCC), we further investigated the correlation between immune microenvironment and prognostic gene expression

  • Previous studies indicated that ferroptosisrelated gene signature, immune-related gene signature, energy metabolism-related gene signature, m6A-related gene signature and hypoxia-related gene signature predict 3-year OS for HCC with area under the curve (AUC) at 0.668, 0.663, 0.69, 0.647 and 0.685 [21,22,23,24,25], respectively, which were similar to our research

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Summary

Introduction

Liver cancer is the sixth most commonly diagnosed cancer and the fourth leading cause of cancer death worldwide [1]. The role of inflammation in the occurrence and development of cancer has always been the focus of people’s research [4,5,6,7]. Studies confirmed many inflammatory response-related features in the peripheral blood of patients with liver cancer, such as thrombocytosis, leukocytosis, hypoproteinemia and elevated plasma fibrinogen [9]. The Glasgow prognosis score composed of C-reactive protein and albumin had independent prognostic value for cancer patients [11]. More and more studies supported the combination of various acute phase proteins to develop comprehensive prognostic scores for cancers based on inflammation. In addition to serum markers, some inflammatory response-related genes were used to predict the metastatic potential of HCC [12]. The prognostic value of inflammatory response-related genes in HCC remains to be further elucidated

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