Abstract
BackgroundPrevious studies have found that the microenvironment of cervical cancer (CESC) affects the progression and treatment of this disease. Thus, we constructed a multigene model to assess the survival of patients with cervical cancer.MethodsWe scored 307 CESC samples from The Cancer Genome Atlas (TCGA) and divided them into high and low matrix and immune scores using the ESTIMATE algorithm for differential gene analysis. Cervical cancer patients were randomly divided into a training group, testing group and combined group. The multigene signature prognostic model was constructed by Cox analyses. Multivariate Cox analysis was applied to evaluate the significance of the multigene signature for cervical cancer prognosis. Prognosis was assessed by Kaplan–Meier curves comparing the different groups, and the accuracy of the prognostic model was analyzed by receiver operating characteristic-area under the curve (ROC-AUC) analysis and calibration curve. The Tumor Immune Estimation Resource (TIMER) database was used to analyze the relationship between the multigene signature and immune cell infiltration.ResultsWe obtained 420 differentially expressed genes in the tumor microenvironment from 307 patients with cervical cancer. A three-gene signature (SLAMF1, CD27, SELL) model related to the tumor microenvironment was constructed to assess patient survival. Kaplan–Meier analysis showed that patients with high risk scores had a poor prognosis. The ROC-AUC value indicated that the model was an accurate predictor of cervical cancer prognosis. Multivariate cox analysis showed the three-gene signature to be an independent risk factor for the prognosis of cervical cancer. A nomogram combining the three-gene signature and clinical features was constructed, and calibration plots showed that the nomogram resulted in an accurate prognosis for patients. The three-gene signature was associated with T stage, M stage and degree of immune infiltration in patients with cervical cancer.ConclusionsThis research suggests that the developed three-gene signature may be applied as a biomarker to predict the prognosis of and personalized therapy for CESC.
Highlights
Previous studies have found that the microenvironment of cervical cancer (CESC) affects the progression and treatment of this disease
A total of 254 patients were diagnosed with squamous cell carcinoma (SCC), 46 patients were diagnosed with adenocarcinoma (AC), and 6 patients were diagnosed with adenosquamous carcinoma (ASC)
The results showed that SCC had the highest matrix score, followed by ASC, and AC had the lowest matrix score (Fig. 1a, P = 0.002)
Summary
Previous studies have found that the microenvironment of cervical cancer (CESC) affects the progression and treatment of this disease. The incidence and mortality rate of CESC were the fourth highest among all cancers in women, suggesting a serious societal burden [1]. The conventional treatment of cervical cancer includes radiotherapy, chemotherapy and surgery, but patients at advanced stages are prone to developing radiotherapy and chemotherapy resistance. Many patients with cervical cancer are already in the advanced stage at the time of diagnosis, which is often accompanied by high invasion rates, and the 3-year or 5-year mortality rate is between 52 and 79% [3,4,5]. It is necessary to find prognostic markers for cervical cancer at the molecular level, which will offer new insight into the treatment and prognosis of cervical cancer
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