Abstract

Glioblastoma (GBM) is the most common primary intracranial tumor with extremely high malignancy and poor prognosis. In order to identify the GBM prognostic biomarkers and establish a prognostic model, we analyzed the expression profile data of GBM in The Cancer Genome Atlas (TCGA) database as the experimental group. First, we identified the differentially expressed genes of different survival periods among the GBM patients. The GISTIC software and Kaplan Meier (KM) survival curve were used to analyze the copy number variation of GBM to identify the survival-associated amplified gene (SAG). We selected the intersection genes of up-regulated ones in short survival group and SAG, performed univariate Cox regression and iterative Lasso regression with them to identify the important candidate genes and establish a prognostic model. Based on the model, the prognostic score was calculated. The patients were divided into high-risk and low-risk groups according to the median prognostic score. Meanwhile ROC curve was used to evaluate the validity of the model, applying the KM survival analysis of the high-risk and low-risk groups. Multivariate Cox regression analysis was used to determine the independence of the prognostic score. All the data were verified with three external datasets: GEO GSE16011, CGGA, and Rembrandt. The results showed that differential expression analysis of different survival periods of GBM identified 426 up-regulated genes and 65 down-regulated genes in the TCGA GBM dataset. The intersection of up-regulated genes in short survival group and SAG yielded 47 genes. After the screening, the six-gene combination (EN2,PPBP,LRRC61,SEL1L3,CPA4,DDIT4L) prognostic model was finally determined. The area under ROC curve of the model in TCGA experimental group and three external validation group were all greater than 0.6, even reaching 0.912. KM analysis showed that the prognosis of the high-risk and low-risk groups was significant different (P<0.05). In the multivariate Cox regression analysis, the six-gene prognostic score was an independent factor influencing the prognosis of GBM patients (P<0.05). In summary, this study established a prognostic model of six-gene (EN2,PPBP,LRRC61,SEL1L3,CPA4,DDIT4L) for GBM. This six-gene model has good predictive ability and could be used as an independent prognostic marker for GBM patients.

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