Clustering analysis and prognostic signature of lung adenocarcinoma based on the tumor microenvironment

Because of immunotherapy failure in lung adenocarcinoma, we have tried to find new potential biomarkers for differentiating different tumor subtypes and predicting prognosis. We identified two subtypes based on tumor microenvironment-related genes in this study. We used seven methods to analyze the immune cell infiltration between subgroups. Further analysis of tumor mutation load and immune checkpoint expression among different subgroups was performed. The least absolute shrinkage and selection operator Cox regression was applied for further selection. The selected genes were used to construct a prognostic 14-gene signature for LUAD. Next, a survival analysis and time-dependent receiver operating characteristics were performed to verify and evaluate the model. Gene set enrichment analyses and immune analysis in risk groups was also performed. According to the expression of genes related to the tumor microenvironment, lung adenocarcinoma can be divided into cold tumors and hot tumors. The signature we built was able to predict prognosis more accurately than previously known models. The signature-based tumor microenvironment provides further insight into the prediction of lung adenocarcinoma prognosis and may guide individualized treatment.