Construction and validation of a nomogram based on N6-Methylandenosine-related lncRNAs for predicting the prognosis of non-small cell lung cancer patients.

Abstract

The N6-methyladenosine (m6 A) can modify long non-coding RNAs (lncRNAs), thereby influencing a wide array of biological functions. However, the prognosis of m6 A-related lncRNAs (m6 ARLncRNAs) in non-small cell lung cancer (NSCLC) remains largely unknown. Pearson correlation analysis was used to identify m6 ARLncRNAs in 1835 NSCLC patients and with the condition (|Pearson R| > 0.4 and p < 0.001). Univariant Cox regression analysis was conducted to explore the prognostic m6 ARLncRNAs. We filtered prognostic m6 ARLncRNAs by LASSO regression and multivariate Cox proportional hazard regression to construct and validate an m6 ARLncRNAs signature (m6 ARLncSig). We analyzed the correlation between the m6 ARLncSig score and clinical features, immune microenvironment, tumor mutation burden, and therapeutic sensitivity and conducted independence and clinical stratification analysis. Finally, we established and validated a nomogram for prognosis prediction in NSCLC patients. Forty-one m6 ARLncRNAs were identified as prognostic lncRNAs, and 12 m6 ARLncRNAs were selected to construct m6 ARLncSig in the TCGA training dataset. The m6 ARLncSig was further validated in the testing dataset, GSE31210, GSE37745, GSE30219, and our NSCLC samples. In terms of m6 ARLncSig, NSCLC patients were divided into high- and low-risk groups, with significantly different overall survival (OS), clinical features (age, sex, and tumor stage), tumor-infiltrating immune cells, chemotherapeutic sensitivity, radiotherapeutic response, and biological pathways. Moreover, m6 ARLncSig independently predicted the OS of NSCLC patients. Finally, the robustness and clinical practicability for predicting NSCLC patient prognosis was improved by constructing a nomogram containing the m6 ARLncSig, age, gender, and tumor stage. Our study demonstrated that m6 ARLncSig could act as a potential biomarker for evaluating the prognosis and therapeutic efficacy in NSCLC patients.