Abstract

Background: Hepatocellular carcinoma (HCC) is the most common histological type of liver cancer, with an unsatisfactory long-term survival rate. Despite immune checkpoint inhibitors for HCC have got glories in recent clinical trials, the relatively low response rate is still a thorny problem. Therefore, there is an urgent need to screen biomarkers of HCC to predict the prognosis and efficacy of immunotherapy. Methods: Gene expression profiles of HCC were retrieved from TCGA, GEO, and ICGC databases while the immune-related genes (IRGs) were retrieved from the ImmPort database. CIBERSORT and WGCNA algorithms were combined to identify the gene module most related to CD8+ T cells in the GEO cohort. Subsequently, the genes in hub modules were subjected to univariate, LASSO, and multivariate Cox regression analyses in the TCGA cohort to develop a risk signature. Afterward, the accuracy of the risk signature was validated by the ICGC cohort, and its relationships with CD8+ T cell infiltration and PDL1 expression were explored. Results: Nine IRGs were finally incorporated into a risk signature. Patients in the high-risk group had a poorer prognosis than those in the low-risk group. Confirmed by TCGA and ICGC cohorts, the risk signature possessed a relatively high accuracy. Additionally, the risk signature was demonstrated as an independent prognostic factor and closely related to the CD8+ T cell infiltration and PDL1 expression. Conclusion: A risk signature was constructed to predict the prognosis of HCC patients and detect patients who may have a higher positive response rate to immune checkpoint inhibitors.

Highlights

  • Being one of the most aggressive malignant tumors in the world, hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related mortality, causing almost 800,000 deaths annually (Bray et al, 2018)

  • We identified a hub module of immune-related genes (IRGs) related to CD8+ T cell infiltration level in HCC, and a risk signature based on genes of the hub module was constructed and validated by bioinformatics analysis

  • Three HCC data sets from public databases were obtained and analyzed in the present study, in which one microarray data set (GSE63898) containing 288 HCC samples from the Gene Expression Omnibus (GEO), and the other two transcriptome sequencing data sets were downloaded from The Cancer Genome Atlas (TCGA) data portal and International Cancer Genome Consortium (ICGC) data portal

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Summary

Introduction

Being one of the most aggressive malignant tumors in the world, hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related mortality, causing almost 800,000 deaths annually (Bray et al, 2018). There exist only two oral multikinase inhibitors, Sorafenib and lenvatinib (Cheng et al, 2009; Kudo et al, 2018), which are recommended by the National Comprehensive Cancer Network (NCCN) guidelines as the first-line therapy for patients with advanced HCC (Hepatobiliary Cancers, 2019). Hepatocellular carcinoma (HCC) is the most common histological type of liver cancer, with an unsatisfactory long-term survival rate. Despite immune checkpoint inhibitors for HCC have got glories in recent clinical trials, the relatively low response rate is still a thorny problem. There is an urgent need to screen biomarkers of HCC to predict the prognosis and efficacy of immunotherapy

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