Abstract

Tumor infiltration, known to associate with various cancer initiations and progressions, is a promising therapeutic target for aggressive cutaneous melanoma. Then, the relative infiltration of 24 kinds of immune cells in melanoma was assessed by a single sample gene set enrichment analysis (ssGSEA) program from a public database. The multiple machine learning algorithms were applied to evaluate the efficiency of immune cells in diagnosing and predicting the prognosis of melanoma. In comparison with the expression of immune cell in tumor and normal control, we built the immune diagnostic models in training dataset, which can accurately classify melanoma patients from normal (LR AUC = 0.965, RF AUC = 0.99, SVM AUC = 0.963, LASSO AUC = 0.964, and NNET AUC = 0.989). These diagnostic models were also validated in three outside datasets and suggested over 90% AUC to distinguish melanomas from normal patients. Moreover, we also developed a robust immune cell biomarker that could estimate the prognosis of melanoma. This biomarker was also further validated in internal and external datasets. Following that, we created a nomogram with a composition of risk score and clinical parameters, which had high accuracies in predicting survival over three and five years. The nomogram's decision curve revealed a bigger net benefit than the tumor stage. Furthermore, a risk score system was used to categorize melanoma patients into high- and low-risk subgroups. The high-risk group has a significantly lower life expectancy than the low-risk subgroup. Finally, we observed that complement, epithelial-mesenchymal transition, and inflammatory response were significantly activated in the high-risk group. Therefore, the findings provide new insights for understanding the tumor infiltration relevant to clinical applications as a diagnostic or prognostic biomarker for melanoma.

Highlights

  • Melanoma is the most aggressive type of cutaneous cancer derived from the melanocyte lineage, with the highest metastasis and mortality rate [1]

  • Melanoma patients were collected from public datasets. e eligible datasets were downloaded from the GEO database and the UCSC Xena website

  • 944 samples were selected for the subsequent analysis, which were acquired from the five datasets, including the TCGA of melanoma, GSE3189, GSE15605, GSE46517, and GSE54467

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Summary

Introduction

Melanoma is the most aggressive type of cutaneous cancer derived from the melanocyte lineage, with the highest metastasis and mortality rate [1]. Despite melanoma contributing to only 5% of all skin-related cancers, it accounts for approximately 80% of deaths related to skin tumors. Surgical enucleation and drug therapy are difficult to treat once it has metastasized [2,3,4]. It is difficult to detect early, and the majority of patients with melanoma were diagnosed at an advanced stage [5, 6]. Cancer treatment guidance and prognosis prediction are largely determined by the TNM staging system. The clinical experience revealed that many patients, even within the same TNM stage, have differences in overall survival [7]. E clinical limitations of the TNM stage are increasingly becoming apparent. Us, it is critical to identify novel biomarkers for early diagnosis and prognostic prediction The clinical experience revealed that many patients, even within the same TNM stage, have differences in overall survival [7]. e clinical limitations of the TNM stage are increasingly becoming apparent. us, it is critical to identify novel biomarkers for early diagnosis and prognostic prediction

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