Increased expression of SMAD5-AS1 in glioma is associated with patient prognosis and immunity

Junqi Ren; Xujun Shan; Hongrong Wu

doi:10.62347/UMTP6161

Increased expression of SMAD5-AS1 in glioma is associated with patient prognosis and immunity

Int J Clin Exp Pathol. 2026 Feb 15;19(2):71-79. doi: 10.62347/UMTP6161. eCollection 2026.

Authors

Junqi Ren¹, Xujun Shan², Hongrong Wu²

Affiliations

¹ Department of Pathology, The Second Affiliated Hospital of Guangdong Medical University Zhanjiang 524001, Guangdong, China.
² Department of Pathology, The Affiliated Hospital of Guangdong Medical University Zhanjiang 524001, Guangdong, China.

Abstract

The aim of this study was to examine the expression profile, clinical significance, and potential diagnostic/prognostic value of the long non-coding RNA (lncRNA) SMAD5-AS1 in glioma.

Methods: Expression of SMAD5-AS1 and its associations with survival were analyzed in patients with lower-grade glioma (LGG) and glioblastoma (GBM) using GEPIA2, R, UALCAN, and TIMER3 platforms.

Results: SMAD5-AS1 was significantly upregulated in multiple cancers, particularly gliomas (LGG and GBM; P < 0.05), demonstrating strong diagnostic performance for GBM (AUC = 0.87) and moderate performance for LGG (AUC = 0.71). In LGG, high SMAD5-AS1 expression was associated with poorer overall survival (HR = 25.53; P < 0.001) and enrichment in higher-grade tumors and astrocytic subtypes (P < 0.01), suggesting a link to tumor aggressiveness. Furthermore, SMAD5-AS1 expression was negatively correlated with infiltration by immunosuppressive cells, implicating a role in modulating the tumor immune microenvironment.

Conclusion: SMAD5-AS1 represents a promising diagnostic and prognostic biomarker in glioma, with elevated expression linked to increased tumor aggressiveness, immunosuppression, and adverse patient outcomes.

Keywords: SMAD5-AS1; glioma; immune infiltration; prognosis.