Abstract
Bladder cancer (BC) is one of the most common malignant urinary system tumors, and its prognosis is poor. In recent years, autophagy has been closely linked to the development of BC. Therefore, we investigated the potential prognostic role of autophagy-related long non-coding RNA (lncRNA) in patients with BC. We obtained the lncRNA information and autophagy genes, respectively, from The Cancer Genome Atlas (TCGA) data set and the human autophagy database (HADb) and performed a co-expression analysis to identify autophagy gene-associated lncRNAs. Then, we divided the data into training group and testing group. In the training group, 15 autophagy-related lncRNAs were found to have a prognostic value (AC026369.3, USP30-as1, AC007991.2, AC104785.1, AC010503.4, AC037198.1, AC010331.1, AF131215.6, AC084357.2, THUMPD3-AS1, U62317.4, MAN1B1-DTt, AC024060.1, AL662844.4, and AC005229.4). The patients were divided into low-risk group and high-risk group based on the prognostic lncRNAs. The overall survival (OS) time for the high-risk group was shorter than that for the low-risk group [risk ratio (hazard ratio, HR) = 1.08, 95% CI: 1.06–1.10; p < 0.0001]. Using our model, the defined risk value can predict the prognosis of a patient. Next, the model was assessed in the TCGA testing group to further validate these results. A total of 203 patients with BC were recruited to verify the lncRNA characteristics. We divided these patients into high-risk group and low-risk group. The results of testing data set show that the survival time of high-risk patients is shorter than that of low-risk patients. In the training group, the area under the curve (AUC) was more than 0.7, indicating a high level of accuracy. The AUC for a risk model was greater than that for each clinical feature alone, indicating that the risk value of a model was the best indicator for predicting the prognosis. Further training data analysis showed that the gene set was significantly enriched in cancer-related pathways, including actin cytoskeleton regulation and gap junctions. In conclusion, our 15 autophagy-related lncRNAs have a prognostic potential for BC, and may play key roles in the biology of BC.
Highlights
Global Cancer Observatory (GCO) data [1] show that ∼550,000 people were diagnosed with bladder cancer (BC) in 2018, making Bladder cancer (BC) the 10th common and 13th most fatal tumor worldwide
Bladder cancer is defined as malignant tumors that occur on the bladder mucosa
A large number of long non-coding RNA (lncRNA) have been analyzed in the diagnosis and prognosis of various cancers
Summary
Global Cancer Observatory (GCO) data (https://gco.iarc.fr/) [1] show that ∼550,000 people were diagnosed with bladder cancer (BC) in 2018, making BC the 10th common and 13th most fatal tumor worldwide. Of all patients with BC, ∼77% are male and BC is the sixth most common cancer in males worldwide. 53% of the patients with BC are more than 70 years old and the mortality is as high as 47%. The diagnosis of BC is mainly dependent on the findings of specimen biopsy, and the treatments for BC have generally included radical/partial cystectomy, neoadjuvant chemotherapy, adjuvant chemotherapy/radiation, and checkpoint inhibitorbased targeted therapies [2,3,4,5,6]. Timely diagnosis and clinical staging of BC for enabling reasonable and effective treatment measures become an urgent problem
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