A Novel Prognostic Model Based On Immunogenomic For Clear Cell Renal Cell Carcinoma

Objective: Immune cell infiltration into tumor tissue is closely related to clinical prognosis of clear cell renal cell carcinoma(cc RCC).This study aimed to screen out potential immune genes associated and analyze their relationships with cc RCC outcomes.Methods:The transcriptome RNA-sequencing data were obtained from the Cancer Genome Atlas(TCGA).A total of 116 down-regulated and 565 up-regulated immune-related differential expressed genes were identified.Pathway enrichment analysis suggested that these genes were mainly enriched in “cytokines and cytokine receptors”.The entire data of cc RCC were randomly divided into the train sets and the test sets according to a ratio of 1:1.A 4-gene signature was then constructed using LASSO Cox analysis and multivariate Cox analysis in the train sets.Results:A total of 681 IRDGs were identified in cc RCC of TCGA database.Four key genes(AGER,INHBE,PDGFD and PDIA2)with high prognostic value and weak correlation were screened out.These genes were closely related to the prognosis of cc RCC.This prognostic signal can successfully divide patients into high-risk and low-risk groups with different clinical prognosis.Combined with the univariate and multivariate analysis of clinical factors,risk score is a prognostic factor that can independently judge the survival of patients.These results are verified in the test set and the entire set.In addition,we found that CD4 + T cells and dendritic cells were significantly enriched in tumor tissues of high-risk group than in low-risk group.Finally,we developed a nomogram incorporating risk score and clinical factors to predict the overall survival of ccrcc patients.These findings may contribute to the study of cc RCC in immunization part.Conclusions:We established a risk score based on these four predictive genes,and constructed a nomogram combined with clinical factors,and proved its practicability.This new model based on IRDGs to predict the prognosis of cc RCC patients also provides a new way to understand the imbalance of tumor immune microenvironment.