Background: Hepatocellular carcinoma (HCC) is one of the most common challenges for public health worldwide. Due to its complex molecular and great heterogeneity, the effectiveness of existing HCC risk prediction models is unsatisfactory. Hence, more accurate prognostic models are pressingly needed.
Materials and methods: Differentially expressed mRNAs (DEMs) between HCC and normal tissues were identified after downloading GSE1450 from gene omnibus (GEO) database. We randomly divided all patients into training and testing sets. Univariate Cox regression, lasso Cox regression and multivariable Cox regression analysis were used to constructed the prognostic gene signature in training set. Our study utilized Kaplan-Meier plot, time-dependent receiver operating characteristic (ROC), multivariable Cox regression analysis with clinical information, nomogram and decision curve analysis (DCA) to evaluate the predictive ability for overall survival of the novel gene signature in training, testing and whole sets. We also validated the prognostic capacity of the five-gene signature in an external validation set. The information of mutation of each gene was explored on cBioPortal online website. We performed gene set enrichment analysis (GSEA) to explore underlying mechanisms in the high and low risk group. Finally, quantitative real-time PCR was conducted to validate the expression tendency between 12 paired HCC and adjacent normal tissues.
Results: Our study constructed a novel five-gene signature (CNIH4, SOX4, SPP1, SORBS2 and CCL19) for predicting overall survival of HCC. Time-dependent ROC curve indicated admirable ability in survival prediction in two datasets. Multivariable Cox regression analysis indicated that both this five-gene signature and TNM stage were two independent prognostic factors for overall survival of HCC patients. Combined with TNM stage clinical pathological parameters, the predictive capacity of nomogram had a decent improvement. The mutation of the five genes had no obvious variation. Plenty pathways were enriched by GSEA, including cell cycle and various metabolism. Furthermore, the mRNA levels of these five genes had signiﬁcantly diﬀerent expressions between HCC tissues and adjacent normal tissues by quantitative real-time PCR.
Conclusions: A five-gene prognostic model and nomogram were constructed and validated for predicting prognostic of HCC patients. And the five-gene risk score with TNM stage models might help various HCC patients to customize individual therapies.