Objective: Cervical cancer poses a remarkable health burden to females globally. Despite major advances in early detection and treatment modalities, some patients still relapse. The present study proposed a novel immune molecular classification that reflected distinct recurrent risk and therapeutic responses in cervical cancer.
Methods: We retrospectively collected two cervical cancer cohorts: TCGA and GSE44001. Consensus clustering approach was conducted based on expression profiling of recurrence- and immune-related genes. The abundance of immune cells was inferred via five algorithms. Immune functions and signatures were quantified through ssGSEA. Genetic mutations were analyzed by maftools package. Immunotherapeutic response was inferred via tumor mutation burden (TMB), Tumor Immune Dysfunction and Exclusion (TIDE), and Submap methods. Finally, we developed a LASSO model for recurrence prediction.
Results: Cervical cancer samples were categorized into two immune subtypes (IC1, and IC2). IC2 exhibited better disease free survival (DFS), increased immune cell infiltration within the immune microenvironment, higher expression of immune checkpoints, higher activity of immune-relevant pathways (APC co-inhibition and co-stimulation, inflammation-promoting, MHC class I, IFN response, leukocyte and stromal fractions, macrophage regulation, and TCR Shannon), and higher frequencies of genetic mutations. This molecular classification exhibited a remarkable difference with existing immune subtypes, with diverse PANoptosis (pyroptosis, apoptosis and necroptosis) features. Patients in IC2 were more likely to respond to immunotherapy and targeted, and chemotherapeutic agents. The immune subtype-relevant signature was quantified to predict patients’ recurrence risk.
Conclusion: Altogether, we developed an immune molecular classification, which can be utilized in clinical practice to aid decision-making on recurrence management.
Background: Owing to the heterogeneity displayed by hepatocellular carcinoma (HCC) and the complexity of tumor microenvironment (TME), it is noted that the long-term effectiveness of the cancer therapy poses a severe clinical challenge. Hence, it is essential to categorize and alter the treatment intervention decisions for these tumors.
Materials and methods: “ConsensusClusterPlus” tool was used for developing a secure molecular classification system that was based on the cuproptosis-linked gene expression. Furthermore, all clinical properties, pathway characteristics, genomic changes, and immune characteristics of different cell types involved in the immune pathways were also assessed. Univariate Cox regression and the least absolute shrinkage and selection operator (Lasso) analyses were used for designing the prognostic risk model associated with cuproptosis.
Results: Three cuproptosis-linked subtypes (clust1, clust2, and clust3) were detected. Out of these, Clust3 showed the worst prognosis, followed by clust2, while Clust1 showed the best prognosis. Three subtypes had significantly different enrichment in pathways related to Tricarboxylic Acid (TCA) cycle, cell cycle, and cell senescence (p < 0.01). The clust3 subtype with poor prognosis had a low “ImmuneScore” and low immune cell infiltration, and the three subtypes had significant differences in the antigen processing and presentation pathway of the macrophages. Clust1 had a low TIDE score and was sensitive to immunotherapy. Then, according to the prognosis-related genes of cuproptosis, a prognosis risk model related to cuproptosis was constructed, containing seven genes (KIF2C, PTTG1, CENPM, CDC20, CYP2C9, SFN, and CFHR3). “High” group had a higher TIDE score compared to the TIDE score value shown by the “Low” group, which benefited less from immunotherapy, whereas the “High” group patients were more sensitive to the conventional drugs. Finally, the prognosis risk model related to cuproptosis was combined with clinical pathological characteristics to further improve the prognostic model and survival prediction.
Conclusion: Three new molecular subgroups based on cuproptosis-linked genes were revealed, and a cuproptosis-related prognostic risk model comprising seven genes was established in this study, which could assist in predicting the prognosis and identifying the patients benefit from immunotherapy.
Frontiers in Genetics
Advances in the Role and Mechanistic Research of RNA Modifications in the Diagnosis, Treatment, and Prognosis of Urological Tumors