Research Article: Combined eight-long noncoding RNA signature: a new risk score predicting prognosis in elderly non-small cell lung cancer patients

Date Published: January 31, 2019

Publisher: Impact Journals

Author(s): Runchen Miao, Cuiyun Ge, Xing Zhang, Yang He, Xiaohua Ma, Xiaohong Xiang, Jingxian Gu, Yunong Fu, Kai Qu, Chang Liu, Qifei Wu, Ting Lin.


The elderly are the majority of patients with non-small cell lung cancer (NSCLC). Compared to the overall population’s predictive guidance, an effective predictive guidance for elderly patients can better guide patients’ postoperative treatment and improve overall survival (OS) and disease-free survival (DFS). Recently, the long non-coding RNAs (lncRNAs) have been found to play an important role in predicting tumor prognosis. To identify potential lncRNAs to predict survival in elderly patients with NSCLC, in the present study, we chose 456 elderly patients with NSCLC and analyzed differentially expressed lncRNAs from four Gene Expression Omnibus (GEO) datasets (GSE30219, GSE31546, GSE37745 and GSE50081). We then constructed an eight-lncRNA formula to predict elderly patients’ prognosis in NSCLC. Furthermore, we validated the prognostic values of the new risk model in two independent datasets, TCGA (n=670) and GSE31210 (n=130). Our data suggested a significant association between risk model and patients’ prognosis. Finally, stratification analysis further revealed the eight-lncRNA signature was an independent factor to predict OS and DFS in stage I elderly patients from both the discovery and validation groups. Functional prediction revealed that 8 lncRNAs have potential effects on tumor immune processes such as lymphocyte activation and TNF production in NSCLC. In summary, our data provides evidence that the eight-lncRNA signature could serve as an independent biomarker to predict prognosis in elderly patients with NSCLC especially in elderly stage I patients.

Partial Text

Non-small cell lung cancer (NSCLC) is one of the most common cause of cancer-related death worldwide [1]. As the population ages, the incidence of lung cancer in the elderly population is increasing. According to the cancer statistics in the past decade, approximately 50% of new lung cancer cases were diagnosed in patients older than 65 [2]. About 81% of lung cancer patients worldwide are over 60 years old, accounting for the majority of lung cancer cases [3]. Moreover, there is evidence that age is an important risk factor for NSCLC patients [4]. If the elderly can be prevented in time and receive the optimal treatment, the incidence of lung cancer, even mortality and recurrence rate will be greatly reduced. Therefore, it is necessary to find more targeted diagnostic and prognostic indicators in elderly patients with lung cancer.

In the present study, we identified a potential eight-lncRNA signature for predicting OS and DFS of elderly NSCLC patients. A total of five GEO and two TCGA datasets were employed in this study. After a comprehensive analysis, eight lncRNA signature was conducted and were identified to be associated with prognosis in elderly NSCLC patients. The ability to predict prognosis has also been confirmed in two other independent datasets. Furthermore, stratified analysis showed that the eight-lncRNA signature had a high predictive accuracy in predicting OS and DFS of NSCLC patients with early stage.




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