Development of Autophagy Signature-Based Prognostic Nomogram for Refined Glioma Survival Prognostication.

The current glioma classification could be optimized to cover such a separate and individualized prognosis ranging from a few months to over ten years. Considering its highly conserved role and potential in therapies, autophagy might be a promising element to be incorporated as a refinement for improved survival prognostication. The expression and RNA-seq data of 881 glioma patients from the Gene Expression Omnibus and The Cancer Genome Atlas were included, mapped with autophagy-related genes. Weighted gene coexpression network analysis and Cox regression analysis were used for the autophagy signature establishment, which composed of , , and . Validations were represented by Kaplan-Meier plots and receiver operating curves (ROC). Cluster analysis suggested the mutant involved in the favorable prognosis of the signature clusters. The signature was also immune-related shown by the Gene Ontology analysis and the Gene Set Enrichment Analysis. The high signature risk group held a higher ESTIMATE score ( = 2.6 - 11) and stromal score ( = 1.8 - 10). CD276 significantly correlated with the signature ( = 0.51, < 0.05). The final nomogram integrated with the autophagy signature, mutation, and pathological grade was built with accuracy and discrimination (1-year survival AUC = 0.812, 5-year survival AUC = 0.822, and 10-year survival AUC = 0.834). Its prognostic value and clinical utility were well-defined by the superiority in the comparisons with the current World Health Organization glioma classification in ROC ( < 0.05) and decision curve analysis. The autophagy signature-based mutation and grade nomogram refined glioma classification for a more individualized and clinically applicable survival estimation and inspired potential autophagy-related therapies.