Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Division of Nephrology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.
J Cell Mol Med. 2020 Feb;24(3):2342-2355. doi: 10.1111/jcmm.14918. Epub 2019 Dec 28.
The precision evaluation of prognosis is crucial for clinical treatment decision of bladder cancer (BCa). Therefore, establishing an effective prognostic model for BCa has significant clinical implications. We performed WGCNA and DEG screening to initially identify the candidate genes. The candidate genes were applied to construct a LASSO Cox regression analysis model. The effectiveness and accuracy of the prognostic model were tested by internal/external validation and pan-cancer validation and time-dependent ROC. Additionally, a nomogram based on the parameter selected from univariate and multivariate cox regression analysis was constructed. Eight genes were eventually screened out as progression-related differentially expressed candidates in BCa. LASSO Cox regression analysis identified 3 genes to build up the outcome model in E-MTAB-4321 and the outcome model had good performance in predicting patient progress free survival of BCa patients in discovery and test set. Subsequently, another three datasets also have a good predictive value for BCa patients' OS and DFS. Time-dependent ROC indicated an ideal predictive accuracy of the outcome model. Meanwhile, the nomogram showed a good performance and clinical utility. In addition, the prognostic model also exhibits good performance in pan-cancer patients. Our outcome model was the first prognosis model for human bladder cancer progression prediction via integrative bioinformatics analysis, which may aid in clinical decision-making.
预后的精确评估对于膀胱癌(BCa)的临床治疗决策至关重要。因此,建立一个有效的膀胱癌预后模型具有重要的临床意义。我们进行了 WGCNA 和 DEG 筛选,以初步确定候选基因。将候选基因应用于构建 LASSO Cox 回归分析模型。通过内部/外部验证和泛癌验证以及时间依赖性 ROC 测试来检验预后模型的有效性和准确性。此外,还基于单因素和多因素 Cox 回归分析中选择的参数构建了列线图。最终筛选出 8 个与膀胱癌进展相关的差异表达候选基因。LASSO Cox 回归分析确定了 3 个基因来构建 E-MTAB-4321 中的结果模型,该结果模型在发现和测试集中对预测 BCa 患者无进展生存期方面表现良好。随后,另外三个数据集对 BCa 患者的 OS 和 DFS 也具有良好的预测价值。时间依赖性 ROC 表明结果模型具有理想的预测准确性。同时,列线图显示出良好的性能和临床实用性。此外,该预后模型在泛癌患者中也表现出良好的性能。我们的结果模型是通过整合生物信息学分析预测人类膀胱癌进展的第一个预后模型,可能有助于临床决策。
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