Development and Validation of an Immune-Related lncRNA Signature for Predicting the Prognosis of Hepatocellular Carcinoma

Aim: Immunotherapy is currently being explored as a potential treatment for hepatocellular carcinoma (HCC). This study investigated the prognostic value of immune-related long non-coding RNAs (lncRNAs) in patients with HCC.

Methods: The Wilcoxon test was used to compare differentially expressed lncRNAs between HCC tissue and non-tumor tissue. Moreover, co-expression analysis was used to determine immune-related lncRNA. Univariate cox regression analysis and the least absolute shrinkage and selection operator (LASSO) regression were used to identify immune-related prognostic lncRNA. The immune risk score was calculated by the sum of the product from each lncRNA expression and its coefficient. Furthermore, the prognostic significance of the lncRNA signature was determined in the training group, testing group, and the entire group. A prognostic nomogram was established by integrating immune risk score and clinicopathological features.

Results: PRRT3-AS1 and AL031985.3 were identified as immune-related prognostic lncRNAs in HCC patients. HCC patients were divided into high and low-risk groups based on the optimal cutoff value of risk score in the training group. The prognosis of HCC patients in the high-risk group was worse compared with the low-risk group. Besides, the immune-related lncRNA score was regarded as an independent risk factor for the prognosis of HCC patients. The predictive nomogram showed satisfactory discrimination and consistency. Gene enrichment analysis results indicated that the high-risk group was associated with immune-related signaling pathways.

Conclusion: This study screened a 2-lncRNA signature and constructed a nomogram to predict the survival of HCC patients, thereby provided guidelines for undertaking medical decisions.