Abstract

BackgroundLung cancer has become the most common cancer type and caused the most cancer deaths. Lung adenocarcinoma (LUAD) is one of the major types of lung cancer. Accumulating evidence suggests the tumor microenvironment is correlated with the tumor progress and the patient’s outcome. This study aimed to establish a gene signature based on tumor microenvironment that can predict patients’ outcomes for LUAD.MethodsDataset TCGA-LUAD, downloaded from the TCGA portal, were taken as training cohort, and dataset GSE72094, obtained from the GEO database, was set as validation cohort. In the training cohort, ESTIMATE algorithm was applied to find intersection differentially expressed genes (DEGs) among tumor microenvironment. Kaplan–Meier analysis and univariate Cox regression model were performed on intersection DEGs to preliminarily screen prognostic genes. Besides, the LASSO Cox regression model was implemented to build a multi-gene signature, which was then validated in the validation cohorts through Kaplan–Meier, Cox, and receiver operating characteristic curve (ROC) analyses. In addition, the correlation between tumor mutational burden (TMB) and risk score was evaluated by Spearman test. GSEA and immune infiltrating analyses were conducted for understanding function annotation and the role of the signature in the tumor microenvironment.ResultsAn eight-gene signature was built, and it was examined by Kaplan–Meier analysis, revealing that a significant overall survival difference was seen. The eight-gene signature was further proven to be independent of other clinico-pathologic parameters via the Cox regression analyses. Moreover, the ROC analysis demonstrated that this signature owned a better predictive power of LUAD prognosis. The eight-gene signature was correlated with TMB. Furthermore, GSEA and immune infiltrating analyses showed that the exact pathways related to the characteristics of eight-genes signature, and identified the vital roles of Mast cells resting and B cells naive in the prognosis of the eight-gene signature.ConclusionIdentifying the eight-gene signature (INSL4, SCN7A, STAP1, P2RX1, IKZF3, MS4A1, KLRB1, and ACSM5) could accurately identify patients’ prognosis and had close interactions with Mast cells resting and B cells naive, which may provide insight into personalized prognosis prediction and new therapies for LUAD patients.

Highlights

  • Lung cancer ranks among the top cancer-related deaths worldwide (Bray et al, 2018)

  • For identifying the Differentially Expressed Genes (DEGs) among immune and stromal scores, cases in the training cohort were divided into groups of high and low scores according to their scores based on the median, and the DEG analysis was performed using the “limma” R package

  • The results showed that the eight-gene signature was significantly positively correlated with tumor mutational burden (TMB) (R = 0.26, p = 4.8e−09, Supplementary Figure S2), further, revealing that the risk score could potentially reflect the characteristics and performance of TMB in tumors

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Summary

Introduction

Lung cancer ranks among the top cancer-related deaths worldwide (Bray et al, 2018). In NSCLC, lung adenocarcinoma (LUAD) is the most common subtype (Cancer Genome Atlas Research and Network, 2014). A large number of patients with advanced LUAD have no targeted mutations. For these patients, studies on immune checkpoints like programmed death 1 (PD-1) and cytotoxic T lymphocyte–associated antigen (CTLA-4) have demonstrated the effectiveness and safety of established treatments (Hellmann et al, 2017; Xu et al, 2018), which highlights the importance of tumor microenvironment on the clinical outcomes of LUAD patients. Lung adenocarcinoma (LUAD) is one of the major types of lung cancer. This study aimed to establish a gene signature based on tumor microenvironment that can predict patients’ outcomes for LUAD

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