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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Developing a prognosis and chemotherapy evaluating model for colon adenocarcinoma based on mitotic
Yinglei Liu1,2, Yamin Zhao1,3, Siming Zhang1
1Nantong Tumor Hospital and Affiliated Tumor Hospital of Nantong University, Nantong, China.
Abstract:
Mitotic catastrophe (MC) is a novel form of cell death that plays an important role in the treatment and drug resistance of colon adenocarcinoma (COAD). However, MC related genes in COAD treatment and prognosis evaluation are rarely studied. In this study, the transcriptome data, somatic mutation and copy number variation data were obtained from The Cancer Genome Atlas (TCGA) database. The mitotic catastrophe related genes (MCRGs) were obtained from GENCARDS website. Differential gene analysis was conducted with LIMMA package. Univariate Cox regression analysis was used to identify prognostic related genes. Mutation analysis was performed and displayed by maftools package. RCircos package was used for localizing the position of genes on chromosomes. "Glmnet" R package was applied for constructing a risk model via the LASSO regression method. Consensus clustering analyses was implemented for clustering different subtypes. Functional enrichment analysis through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) methods, immune infiltration analysis via single sample gene set enrichment analysis (ssGSEA), tumor mutation burden and drug sensitivity analysis by pRRophetic R package were also carried out for risk model or molecular subtype's assessment. Additionally, the connections between the expression of hub genes and overall survival (OS) were obtained from online Human Protein Atlas (HPA) website. Real-Time Quantitative Polymerase Chain Reaction (RT‑qPCR) further validated the expression of hub genes. A total of 207 differentially expressed MCRGs were selected in the TCGA cohort, 23 of which were significantly associated with OS in COAD patients. Subsequently, we constructed risk score prognostic models with 5 hub MCRGs, including SYCE2, SERPINE1, TRIP6, LIMK1, and EEPD1. The high-risk patients suffered from poorer prognosis. Furthermore, we developed a nomogram that gathered age, sex, staging, and risk score to accurately forecast the clinical survival outcomes in 1, 3, and 5 years. The results of functional enrichment suggested a significant correlation between MCRGs characteristics and cancer progression, with important implications for the immune microenvironment. Moreover, patients who displayed high TMB and high risk score showed worse prognosis, and risk characteristics were associated with different chemotherapeutic agents. Finally, RT‑qPCR verified the increased expression of the five MCRGs in clinical samples. The five MCRGs in the prognostic signature were associated with prognosis, and could be treated as reliable prognostic biomarkers and therapeutic targets for COAD patients with distinct clinicopathological characteristics, thereby providing a foundation for the precise application of pertinent drugs in COAD patients.
Insights
Mitotic catastrophe related genes (MCRGs) are crucial for colon adenocarcinoma (COAD) prognosis. A 5-gene signature predicts patient survival and response to therapy, offering new therapeutic targets.
Area of Science:
- Oncology
- Cell Death Research
- Genomics
Background:
- Mitotic catastrophe (MC) is a cell death pathway significant in colon adenocarcinoma (COAD) treatment and drug resistance.
- Understanding MC-related genes is vital for COAD prognosis and therapeutic strategies, yet remains underexplored.
Purpose of the Study:
- To identify and analyze mitotic catastrophe-related genes (MCRGs) in colon adenocarcinoma.
- To develop a prognostic model and explore therapeutic targets based on MCRGs.
Main Methods:
- Utilized TCGA data for transcriptome, mutation, and copy number variations.
- Performed differential gene expression, univariate Cox regression, and LASSO regression for prognostic model construction.
- Conducted functional enrichment, immune infiltration, tumor mutation burden, and drug sensitivity analyses.
Main Results:
- Identified 207 differentially expressed MCRGs, with 23 significantly linked to overall survival (OS) in COAD.
- Developed a 5-hub MCRG prognostic model (SYCE2, SERPINE1, TRIP6, LIMK1, EEPD1) where high risk correlates with poorer prognosis.
- Created a nomogram integrating clinical factors and risk score for accurate survival prediction; linked MCRGs to immune microenvironment and chemotherapeutic response.
Conclusions:
- The 5-hub MCRG signature serves as a reliable prognostic biomarker for COAD.
- These MCRGs represent potential therapeutic targets for personalized treatment strategies in COAD patients.
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