A novel 17 apoptosis-related genes signature could predict overall survival for bladder cancer and its associations with immune infiltration.

ABSTRACT

Background: Apoptosis-related genes (ARGs) were used to develop a novel signature for forecasting overall survival (OS) and examining their relationships with immune infiltrates in bladder cancer (BC). Methods: Gene expression matrices as well as related clinical data were acquired for BC samples from online datasets. According to differentially expressed ARGs acquired from normal bladder tissues and cancer samples, functional enrichment analyses were conducted. With the assistance of LASSO and Cox regression analysis, a novel model was successfully established and evaluated by external and internal validations. Results: Eventually, 17 ARGs (SLC5A6, GULP1, TAP1, MMP9, P4HB, FOXL2, CIDEC, EN2, NES, EPHA7, SUSD2, TMPRSS3, HOXB7, SATB1, MEST, PCDHGC3, ASPM) were utilized to construct the signature. Our constructed signature significantly distinguished high-risk from low-risk BC patients of OS by internal and external validations and was also proven to be able to serve as an independent prognostic biomarker (all P < 0.05). Furthermore, a prognostic nomogram was also constructed based on TCGA dataset to predict OS prognosis in BC suffers. Besides, this ARG based model was markedly associated with clinical characteristics like tumor stage (P = 3.98e-06), race (P = 8.255e-06), N stage (P = 0.002), T stage (P = 3.679e-05) and M stage (P = 0.002). As for immune infiltration, our established model was significantly associated with seven tumor-infiltrating immune cells. Conclusions: A prognostic signature was successfully developed by us according to 17 ARGs in BC using external and internal verifications, enabling clinicians to predict BC suffers' OS and promote specific individualization of patient care.