A Proteogenomic Approach to Discover Novel lncRNA-Derived Microproteins and Their Potential Clinical Utility in...

Microproteins (i.e., peptides) are increasingly recognized for their functions in versatile biological contexts, but their clinical relevance and utility remain largely unexplored. Proteogenomic approaches can accelerate microprotein discovery in clinical samples by integrating proteomic data with genomics and transcriptomics evidence. However, long noncoding RNA (lncRNA)-derived microproteins (lncPeps) remain largely unidentified, resulting in unmatchable MS/MS spectra. To solve this problem, we have used high-quality Ribo-seq translatomic datasets to generate an extensive database of human liver lncRNA-derived open reading frames (lncORFs), which we subsequently applied to proteomics data of tumor-adjacent normal tissue pairs from hepatocellular carcinoma (HCC) patients. Using the new database, we discovered 104 novel lncPeps, including 46 lncPeps differentially expressed between tumor and nontumor tissues, and 13 lncPeps with significant correlation with prognosis. Remarkably, combining the expression of lncPeps with canonical proteins in a LASSO regression model improved predictive performance for recurrence, increasing the AUC by 0.005 to 0.085 across three recurrence time points. These findings suggest that the discovery of lncPeps contributes to our understanding of the molecular heterogeneity and progression of HCC and broadens the range of potential biomarker candidates and treatment targets for the disease.