Abstract

Growing evidence suggests that immune-related genes (IRGs) and long non-coding RNAs (lncRNAs) can serve as prognostic markers of overall survival (OS) in patients with colon cancer. This study aimed to identify an immune-related lncRNA signature for the prospective assessment of prognosis in these patients. Gene expression and clinical data of colon cancer patients were downloaded from The Cancer Genome Atlas (TCGA). Immune-related lncRNAs were identified by a correlation analysis between IRGs and lncRNAs. In total, 447 samples were divided into a training cohort (224 samples) and a testing cohort (223 samples). Univariate, lasso and multivariate Cox regression analyses identified an immune-related nine-lncRNA signature closely related to OS in colon cancer patients in the training dataset. A risk score formula involving nine immune-related lncRNAs was developed to evaluate the prognostic value of the lncRNA signature in the training dataset. Colon cancer patients with a high risk score had poorer OS than those with a low risk score. A multivariate Cox regression analysis confirmed that the immune-related nine-lncRNA signature could be an independent prognostic factor in colon cancer patients. The results were further confirmed in the testing cohort and the entire TCGA cohort. Furthermore, a gene set enrichment analysis revealed several pathways with significant enrichment in the high- and low-risk groups that may be helpful in formulating clinical strategies and understanding the underlying mechanisms. Finally, a quantitative real-time polymerase chain reaction assay found that the nine lncRNAs were significantly differentially expressed in colon cancer cell lines. The results of this study indicate that this signature has important clinical implications for improving predictive outcomes and guiding individualized treatment in colon cancer patients. These lncRNAs could be potential biomarkers affecting the prognosis of colon cancer.

Highlights

  • Colon cancer is a common malignant tumor of the digestive tract

  • We identified an immunerelated nine-long non-coding RNAs (lncRNAs) signature associated with the prognosis of colon cancer patients in the training cohort that performed well in the testing cohort and the entire The Cancer Genome Atlas (TCGA) cohort

  • Studies have found that lncRNAs are important regulators of the immune response in cancer

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Summary

Introduction

Colon cancer is a common malignant tumor of the digestive tract. A study found that the incidence and mortality of colon cancer have gradually increased in recent years (Bray et al, 2018). Role of lncRNAs in CRC assessment model is urgently needed to assess the survival prognosis of patients with colon cancer and optimize clinical treatment decisions. Genomic research has greatly enhanced our understanding of the mechanism underlying colon cancer development (Coebergh van den Braak et al, 2018) and revealed the potential value of molecular biomarkers in the diagnosis and evaluation of survival prognosis in patients with colon cancer (Galamb et al, 2019; Xu et al, 2019). Individualized treatment plans can be tailored to different patients with colon cancer to improve their survival prognosis

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