Liu Ji, Zhang Wentao, Lin Kang, Ma Wenchao, Li Wei, Yao Xudong
Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Urologic Cancer Institute, Tongji University School of Medicine, Shanghai, China.
Ann Transl Med. 2021 Oct;9(20):1544. doi: 10.21037/atm-21-4973.
Clear cell renal cell carcinoma (ccRCC) is the most common malignancy affecting the kidneys, accounting for approximately 75% of all kidney tumors. Recently, the impact of immune response, immunotherapy, and immune-related genes (IRGs) on tumor development has received much attention. This study sought to establish a reliable immunological signature and further explore whether this signature has prognostic significance in ccRCC patients.
Differentially expressed IRGs in 611 patients with diagnosis of ccRCC from The Cancer Genome Atlas (TCGA) were analyzed along with the corresponding survival time and disease clinical data. Survival analysis, selection operator Cox analysis, and minimum absolute shrinkage were applied to establish an IRG prognostic signature (IRGPS). The expression levels of relevant genes were detected by real-time quantitative PCR. A Nomogram was used to explore the possible impact of the IRGPS on the immune system, prognosis, and metastasis, and the associated mechanisms were explored through functional enrichment analysis.
An IRGPS was established based on eight prognostic IRGs and was found to be closely associated with immune levels, metastasis, and prognosis. The IRGPS was determined to be a valid predictor of the efficacy of immune checkpoint inhibitors (ICIs). Three Nomograms based on the IRGPS and other clinical features were developed and could effectively predict prognosis, distant metastasis, and lymph node metastasis in patients with ccRCC.
The IRGPS constructed in this study serves as a tool for assessing immune status, developing individualized treatment regimens, and predicting prognosis in patients with ccRCC.
透明细胞肾细胞癌（ccRCC）是影响肾脏的最常见恶性肿瘤，约占所有肾肿瘤的75%。近年来，免疫反应、免疫治疗及免疫相关基因（IRGs）对肿瘤发展的影响备受关注。本研究旨在建立一个可靠的免疫特征，并进一步探讨该特征在ccRCC患者中是否具有预后意义。
分析了来自癌症基因组图谱（TCGA）的611例ccRCC诊断患者中差异表达的IRGs，以及相应的生存时间和疾病临床数据。应用生存分析、选择算子Cox分析和最小绝对收缩法建立IRG预后特征（IRGPS）。通过实时定量PCR检测相关基因的表达水平。使用列线图探讨IRGPS对免疫系统、预后和转移的可能影响，并通过功能富集分析探索相关机制。
基于8个预后IRGs建立了IRGPS，发现其与免疫水平、转移和预后密切相关。IRGPS被确定为免疫检查点抑制剂（ICIs）疗效的有效预测指标。基于IRGPS和其他临床特征开发了3个列线图，可有效预测ccRCC患者的预后、远处转移和淋巴结转移。
本研究构建的IRGPS可作为评估ccRCC患者免疫状态、制定个体化治疗方案和预测预后的工具。
