Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University and The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China.
Affiliated Hospital of Southwest Jiaotong University, Chengdu 610036, China.
Aging (Albany NY). 2021 Jul 11;13(13):17734-17767. doi: 10.18632/aging.203266.
Limited progress has been made in the treatment of gastric adenocarcinoma (GAC) in recent years, but the potential of immunotherapy in GAC is worthy of consideration. The purpose of this study was to develop a reliable, personalized signature based on immune genes to predict the prognosis of GAC. Here, we identified two groups of patients with significantly different prognoses by performing unsupervised clustering analysis of The Cancer Genome Atlas (TCGA) database based on 881 immune genes. The immune signature was constructed with a training set composed of 350 GAC samples from the TCGA and subsequently validated with 431 samples from GSE84437, 432 samples from GSE26253, and 145 GAC samples from real-time quantitative reverse transcription polymerase chain reaction data. This classification system can also be used to predict prognosis in different clinical subgroups. Further analysis suggested that high-risk patients were characterized by low immune scores, distinctive immune cell proportions, different immune checkpoint profiles, and a low tumor mutational burden. Ultimately, the signature was identified as an independent prognostic factor. In general, the signature can accurately predict recurrence and overall survival in patients with GAC and may serve as a powerful prognostic tool to further optimize cancer immunotherapy.
近年来，胃腺癌（GAC）的治疗进展有限，但免疫疗法在 GAC 中的潜力值得考虑。本研究旨在基于免疫基因开发一种可靠的、个性化的签名，以预测 GAC 的预后。在这里，我们通过对 TCGA 数据库中的 881 个免疫基因进行无监督聚类分析，确定了两组具有显著不同预后的患者。该免疫特征由 TCGA 中的 350 个 GAC 样本的训练集构建，并随后使用来自 GSE84437 的 431 个样本、来自 GSE26253 的 432 个样本和来自实时定量逆转录聚合酶链反应数据的 145 个 GAC 样本进行验证。该分类系统也可用于预测不同临床亚组的预后。进一步分析表明，高风险患者的特征是免疫评分低、独特的免疫细胞比例、不同的免疫检查点特征以及肿瘤突变负担低。最终，该签名被确定为一个独立的预后因素。总的来说，该签名可以准确预测 GAC 患者的复发和总生存期，并且可能成为一种强大的预后工具，以进一步优化癌症免疫治疗。
