| الوصف: |
Background：Bladder urothelial carcinoma (BLCA) is a malignant tumor occurring in the bladder and derived from urothelial cells. It is one of the ten most common cancers in the world. There has been no significant progress in the treatment of patients with recurrence of BLCA in the past decades. With the progress of systemic treatment, the overall survival period (OS) of patients has improved, but the prognosis is still poor, which needs improvement clinically. The development of immunotherapy has changed the status initially. Natural killer (NK) cells, as an important type of innate immunomodulatory cells, have proved their potential in the treatment of several malignant tumors, so which received widespread attention in recent years. Objective: The clinical data in TCGA and GEO was used to provide ideas for the diagnosis, treatment and evaluation of prognosis indicators of BLCA. And the relationship between BLCA and the expression of NRGs was investigated. Methods: In this study, the normal and tumor samples of TCGA-BLCA and GSE3167 were analyzed to find out differential expression genes based on the "limma" R package. The genes and the natural killer cell-related genes (NRGs) were intersected to obtain NRGs with differential expression. We used univariate COX regression analysis, LASSO and multifactor COX analysis to obtain the risk score and build the prognosis gene model. GSE31684 queue has been verified externally. In order to further confirm the reliability of genes, we analyzed their mechanism of action, divided them into groups by the risk score, and performed immune analysis on subgroups to evaluate the immune treatment response. Results: There are differences in the expression of LRP1 and INHBB, which are independent risk factors for the prognosis of BLCA. The nomogram was established based on the characteristics of 2-NRGs and clinicopathological characteristics. The low risk group has more abundant immune infiltration, suggesting a better immune response and better prognosis, which verifies the reliability of grouping. The sensitivity of the hig-risk and low-risk group to the two target sites, PDL1 and FGFR3, is significantly different. And the risk score is closely related to the relevant chemotherapy drugs. These suggested that the risk score can screen the patients well at the drug level, and also providing a meaningful reference for the patients in drug selection. Conclusion: NK cell core genes, LRP1 and INHBB, may play a crucial role in the occurrence and progression of BLCA. We constructed nomogram according to the NK core genes and verified its feasibility, which can provide a reference for clinical prognosis. |
