Development of a Prognostic Model for Colorectal Cancer Based on Four EMT-related Genes

Abstract

Background: Epithelial-to-mesenchymal transition (EMT) greatly affects the progression and metastasis of colorectal cancer (CRC) which is one of the most malignant tumors. The goal of this study was to evaluate the prognostic value of EMT-related genes and develop a prognostic nomogram for patients’ overall survival (OS) with CRC. Methods: This retrospective study analyzed gene expression profiles and clinical data in 1099 samples of CRC patients from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Risk signature based on public databases was created and examined for its predictive value in CRC patients. The independence and correlation of risk signature with clinicopathological parameters were respectively evaluated through univariate/multivariate analysis and subgroup analysis. A nomogram was established according to risk signature and clinical parameters and validated for its predictive ability. The correlation of risk signature and infiltrating immune cells in CRC was assessed.Results: A four EMT-related genes (ERGs) based signature was constructed and validated for its ability in prognostic prediction in CRC patients. The results showed the ERGs signature as an independent prognostic factor regarding different clinicopathological parameters including age, gender and clinical stage. Besides, the ERGs signature also performed well in subgroup analysis with T3-T4, N-, M0 and early disease stage. A nomogram based on the ERGs signature combining clinical parameters was constructed which showed a promising predictive ability in prognosis of CRC patients’ OS. In addition, we found a positive correlation of the ERGs signature with six different types of immune cells.Conclusion: A novel ERGs signature was identified in this study and ERGs signature can be useful in predicting the prognosis of CRC patients.