Nine-long non-coding ribonucleic acid signature can improve the survival prediction of colorectal cancer

Zhen Zong; Ce-Gui Hu; Tai-Cheng Zhou; Zhuo-Min Yu; Fu-Xin Tang; Hua-Kai Tian; Hui Li; He Wang

doi:10.4240/wjgs.v13.i2.210

Nine-long non-coding ribonucleic acid signature can improve the survival prediction of colorectal cancer

World J Gastrointest Surg. 2021 Feb 27;13(2):210-221. doi: 10.4240/wjgs.v13.i2.210.

Authors

Zhen Zong¹, Ce-Gui Hu¹, Tai-Cheng Zhou², Zhuo-Min Yu², Fu-Xin Tang², Hua-Kai Tian¹, Hui Li³, He Wang⁴

Affiliations

¹ Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
² Department of Gastrointestinal Surgery and Hernia Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China.
³ Department of Rheumatology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
⁴ Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China. wanghe2000@163.com.

Abstract

Background: Investigating molecular biomarkers that accurately predict prognosis is of considerable clinical significance. Accumulating evidence suggests that long non-coding ribonucleic acids (lncRNAs) are frequently aberrantly expressed in colorectal cancer (CRC).

Aim: To elucidate the prognostic function of multiple lncRNAs serving as biomarkers in CRC.

Methods: We performed lncRNA expression profiling using the lncRNA mining approach in large CRC cohorts from The Cancer Genome Atlas (TCGA) database. Receiver operating characteristic analysis was performed to identify the optimal cutoff point at which patients could be classified into the high-risk or low-risk groups. Based on the Cox coefficient of the individual lncRNAs, we identified a nine-lncRNA signature that was associated with the survival of CRC patients in the training set (n = 175). The prognostic value of this nine-lncRNA signature was validated in the testing set (n = 174) and TCGA set (n = 349). The prognostic models, consisting of these nine CRC-specific lncRNAs, performed well for risk stratification in the testing set and TCGA set. Time-dependent receiver operating characteristic analysis indicated that this predictive model had good performance.

Results: Multivariate Cox regression and stratification analysis demonstrated that this nine-lncRNA signature was independent of other clinical features in predicting overall survival. Functional enrichment analysis of Kyoto Encyclopedia of Genes and Genomes pathways and Gene Ontology terms further indicated that these nine prognostic lncRNAs were closely associated with carcinogenesis-associated pathways and biological functions in CRC.

Conclusion: A nine-lncRNA expression signature was identified and validated that could improve the prognosis prediction of CRC, thereby providing potential prognostic biomarkers and efficient therapeutic targets for patients with CRC.

Keywords: Biomarkers; Colorectal cancer; Long non-coding ribonucleic acid; Survival prediction; The Cancer Genome Atlas; Therapeutic targets.