Macrophage-Associated Genes for Predicting Prognosis and the Tumor Microenvironment in Patients with Hepatocellular Carcinoma.

Background: Hepatocellular carcinoma (HCC) is a highly malignant tumor, which is difficult to treat and has a poor prognosis. Immunotherapy has been a hot topic in liver cancer treatment in recent years, and macrophages play an important role in liver cancer immunotherapy. In this paper, we will use bioinformatics to analyze the significance of macrophage-associated genes (Mags) in hepatocellular carcinoma. Our goal is to determine the impact of macrophage-related genes on the immunotherapy, prognosis, and tumor microenvironment of HCC patients. Methods: 343 HCC patients with complete survival data were selected from RNA sequencing data from the Cancer Genome Atlas Hepatocellular carcinoma (TCGA-LIHC) database. Using univariate Cox regression analysis and Lasso regression analysis to identify macrophage-related genetic markers for prognostic HCC and constructed risk scores. Kaplan-Meier survival analysis helped to determine the relationship between genetic markers and overall survival (OS). Kaplan-Meier analysis was used to compare OS in stratified high-risk and low-risk groups. Risk scores and other clinical features were included to develop a prognostic profile of HCC. The accuracy of the model was evaluated by the receiver operating curve and calibration curve, respectively. Results: A prognostic risk model consisting of 7 Mags was constructed to accurately predict OS in the TCGA cohort. In univariate and multivariate Cox regression analyses, risk scores were prognostic factors independent of other clinical factors. The prognostic histogram showed that risk score had a good prognostic effect on survival risk stratification. The expression of immunotherapy markers such as CTLA4 and TNFRSF9 was upregulated in high-risk patients, indicating an underlying immunotherapy response in these patients. Conclusion: Our study constructs a macrophage-associated genetic marker for predicting OS in HCC patients, which may help guide clinical immunotherapy.