Abstract

BackgroundTumor microenvironment (TME) plays important roles in different cancers. Our study aimed to identify molecules with significant prognostic values and construct a relevant Nomogram, immune model, competing endogenous RNA (ceRNA) in lung adenocarcinoma (LUAD).Methods“GEO2R,” “limma” R packages were used to identify all differentially expressed mRNAs from Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. Genes with P-value <0.01, LogFC>2 or <-2 were included for further analyses. The function analysis of 250 overlapping mRNAs was shown by DAVID and Metascape software. By UALCAN, Oncomine and R packages, we explored the expression levels, survival analyses of CDK2 in 33 cancers. “Survival,” “survminer,” “rms” R packages were used to construct a Nomogram model of age, gender, stage, T, M, N. Univariate and multivariate Cox regression were used to establish prognosis-related immune forecast model in LUAD. CeRNA network was constructed by various online databases. The Genomics of Drug Sensitivity in Cancer (GDSC) database was used to explore correlations between CDK2 expression and IC50 of anti-tumor drugs.ResultsA total of 250 differentially expressed genes (DEGs) were identified to participate in many cancer-related pathways, such as activation of immune response, cell adhesion, migration, P13K-AKT signaling pathway. The target molecule CDK2 had prognostic value for the survival of patients in LUAD (P = 5.8e-15). Through Oncomine, TIMER, UALCAN, PrognoScan databases, the expression level of CDK2 in LUAD was higher than normal tissues. Pan-cancer analysis revealed that the expression, stage and survival of CDK2 in 33 cancers, which were statistically significant. Through TISIDB database, we selected 13 immunodepressants, 21 immunostimulants associated with CDK2 and explored 48 genes related to these 34 immunomodulators in cBioProtal database (P < 0.05). Gene Set Enrichment Analysis (GSEA) and Metascape indicated that 49 mRNAs were involved in PUJANA ATM PCC NETWORK (ES = 0.557, P = 0, FDR = 0), SIGNAL TRANSDUCTION (ES = –0.459, P = 0, FDR = 0), immune system process, cell proliferation. Forest map and Nomogram model showed the prognosis of patients with LUAD (Log-Rank = 1.399e-08, Concordance Index = 0.7). Cox regression showed that four mRNAs (SIT1, SNAI3, ASB2, and CDK2) were used to construct the forecast model to predict the prognosis of patients (P < 0.05). LUAD patients were divided into two different risk groups (low and high) had a statistical significance (P = 6.223e-04). By “survival ROC” R package, the total risk score of this prognostic model was AUC = 0.729 (SIT1 = 0.484, SNAI3 = 0.485, ASB2 = 0.267, CDK2 = 0.579). CytoHubba selected ceRNA mechanism medicated by potential biomarkers, 6 lncRNAs-7miRNAs-CDK2. The expression of CDK2 was associated with IC50 of 89 antitumor drugs, and we showed the top 20 drugs with P < 0.05.ConclusionIn conclusion, our study identified CDK2 related immune forecast model, Nomogram model, forest map, ceRNA network, IC50 of anti-tumor drugs, to predict the prognosis and guide targeted therapy for LUAD patients.

Highlights

  • Lung cancer is the third leading cause of death in the world (Siegel et al, 2020; Kara et al, 2021), which is classified into small cell lung cancer (SCLC), lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD) (Wu Y. et al, 2021)

  • Through Metascape software, we identified a number of pathways significantly enriched, including activation of immune response, regulation of cell adhesion, T cell activation involved in immune response, regulation of cell adhesion, PID-HNF3B PATHWAY (Figure 3A)

  • DAVID was used to analyze the Kyoto Encyclopedia of Genes and Genomes (KEGG) results of genes and we found 9 mRNAs participated in the classic P13-AKT signaling pathway, such as MYB, COL3A1, COL4A1, CSF1R, CDK2, ITGB7, LAMA2, TLR2, and VWF

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Summary

Introduction

Lung cancer is the third leading cause of death in the world (Siegel et al, 2020; Kara et al, 2021), which is classified into small cell lung cancer (SCLC), lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD) (Wu Y. et al, 2021). Non-small cell lung cancer (NSCLC) accounted for 85% of lung cancer and the 5-year survival rate of the patients is less than 20% (Bade and Dela Cruz, 2020). LUAD is the most important type of NSCLC (Chen and Zhou, 2021; Hou and Yao, 2021; Zhou C. et al, 2021). The treatment of lung cancer is diversified, such as chemotherapy, immunotherapy, targeted therapy, the prognosis of patients with advanced lung cancer is still poor (Noreldeen et al, 2020; Wang et al, 2020). More than 60% of LUAD patients missed the best targeted treatment time due to the difficulty of diagnosis, which can reduce the survival rate (Kris et al, 2014; Chen et al, 2016). Our study aimed to identify molecules with significant prognostic values and construct a relevant Nomogram, immune model, competing endogenous RNA (ceRNA) in lung adenocarcinoma (LUAD)

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