Wang Junli, Zhang Qi, Shi Fukang, Yadav Dipesh Kumar, Hong Zhengtao, Wang Jianing, Liang Tingbo, Bai Xueli
Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Genet. 2021 Sep 16;12:728476. doi: 10.3389/fgene.2021.728476. eCollection 2021.
Hepatocellular carcinoma (HCC) is one of the most prevalent malignant diseases worldwide and has a poor prognosis. Gene-based prognostic models have been reported to predict the overall survival of patients with HCC. Unfortunately, most of the genes used in earlier prognostic models lack prospective validation and, thus, cannot be used in clinical practice. Candidate genes were selected from GEPIA (Gene Expression Profiling Interactive Analysis), and their associations with patients' survival were confirmed by RT-PCR using cDNA tissue microarrays established from patients with HCC after radical resection. A multivariate Cox proportion model was used to calculate the coefficient of corresponding gene. The expression of seven genes of interest (, and ) with two reference genes was defined to calculate a risk score which determined groups of different risks. Our risk scoring efficiently classified patients ( = 129) with HCC into a low-, intermediate-, and high-risk group. The three groups showed meaningful distinction of 3-year overall survival rate, i.e., 88.9, 74.5, and 20.6% for the low-, intermediate-, and high-risk group, respectively. The prognostic prediction model of risk scores was subsequently verified using an independent prospective cohort ( = 77) and showed high accuracy. Our seven-gene signature model performed excellent long-term prediction power and provided crucially guiding therapy for patients who are not a candidate for surgery.
肝细胞癌(HCC)是全球最常见的恶性疾病之一,预后较差。据报道,基于基因的预后模型可预测HCC患者的总生存期。不幸的是,早期预后模型中使用的大多数基因缺乏前瞻性验证,因此不能用于临床实践。从GEPIA(基因表达谱交互式分析)中选择候选基因,并使用从根治性切除术后的HCC患者建立的cDNA组织微阵列通过RT-PCR确认它们与患者生存的相关性。使用多变量Cox比例模型计算相应基因的系数。定义七个感兴趣基因(、和)与两个参考基因的表达以计算风险评分,该评分确定不同风险组。我们的风险评分有效地将129例HCC患者分为低、中、高风险组。这三组的3年总生存率有显著差异,即低风险组为88.9%,中风险组为74.5%,高风险组为20.6%。随后使用独立的前瞻性队列(77例)验证了风险评分的预后预测模型,显示出高准确性。我们的七基因特征模型具有出色的长期预测能力,为不适合手术的患者提供了至关重要的治疗指导。