Abstract
BackgroundAccumulating evidence has demonstrated that immune-related lncRNAs (IRLs) are commonly aberrantly expressed in breast cancer (BC). Thus, we aimed to establish an IRL-based tool to improve prognosis prediction in BC patients.MethodsWe obtained IRL expression profiles in large BC cohorts (N = 911) from The Cancer Genome Atlas (TCGA) database. Then, in light of the correlation between each IRL and recurrence-free survival (RFS), we screened prognostic IRL signatures to construct a novel RFS nomogram via a Cox regression model. Subsequently, the performance of the IRL-based model was evaluated through discrimination, calibration ability, risk stratification ability and decision curve analysis (DCA).ResultsA total of 52 IRLs were obtained from TCGA. Based on multivariate Cox regression analyses, four IRLs (A1BG-AS1, AC004477.3, AC004585.1 and AC004854.2) and two risk parameters (tumor subtype and TNM stage) were utilized as independent indicators to develop a novel prognostic model. In terms of predictive accuracy, the IRL-based model was distinctly superior to the TNM staging system (AUC: 0.728 VS 0.673, P = 0.010). DCA indicated that our nomogram had favorable clinical practicability. In addition, risk stratification analysis showed that the IRL-based tool efficiently divided BC patients into high- and low-risk groups (P < 0.001).ConclusionsA novel IRL-based model was constructed to predict the risk of 5-year RFS in BC. Our model can improve the predictive power of the TNM staging system and identify high-risk patients with tumor recurrence to implement more appropriate treatment strategies.
Highlights
Accumulating evidence has demonstrated that immune-related long noncoding RNAs (lncRNAs) (IRLs) are commonly aberrantly expressed in breast cancer (BC)
LncRNA SNHG1 enhances the differentiation of Treg cells to provoke immune escape in BC [26]
Patients and study design Gene and lncRNA expression profiles as well as corresponding BC cases information were acquired from The Cancer Genome Atlas (TCGA) database
Summary
Accumulating evidence has demonstrated that immune-related lncRNAs (IRLs) are commonly aberrantly expressed in breast cancer (BC). Increasing evidence has revealed that molecular biomarkers have the potential to improve prognostic assessment and identify high-risk cancer patients [8,9,10,11,12,13,14]. There is an urgent need to screen effective molecular biomarkers for improving survival prognosis prediction and identify high-risk BC patients with tumor recurrence. Accumulating evidence indicates that lncRNAs play important roles in various biological processes, including transcriptional modifications, cell proliferation, differentiation, epigenetic modulation, and immune system-modulated pathways [20,21,22,23,24,25]. The role of immunerelated lncRNAs (IRLs) in the prognostic evaluation of BC remains unclear
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