Tumor infiltrating immune cells (TIICs) as a biomarker for prognosis benefits in patients with osteosarcoma
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RESEARCH ARTICLE
Open Access
Tumor infiltrating immune cells (TIICs) as a biomarker for prognosis benefits in patients with osteosarcoma Ying Chen1, Bo Zhao2 and Xiaohu Wang2*
Abstract Background: Osteosarcoma is a rare malignant bone tumor in adolescents and children. Poor prognosis has always been a difficult problem for patients with osteosarcoma. Recent studies have shown that tumor infiltrating immune cells (TIICs) are associated with the clinical outcome of osteosarcoma patients. The aim of our research was to construct a risk score model based on TIICs to predict the prognosis of patients with osteosarcoma. Methods: CIBERSORTX algorithm was used to calculate the proportion of 22 TIIC types in osteosarcoma samples. Kaplan-Meier curves were drawn to investigate the prognostic value of 22 TIIC types. Forward stepwise approach was used to screen a minimal set of immune cell types. Multivariate Cox PHR analysis was performed to construct an immune risk score model. Results: Osteosarcoma samples with CIBERSORTX output p value less than 0.05 were selected for research. KaplanMeier curves indicated that naive B cells (p = 0.047) and Monocytes (p = 0.03) in osteosarcoma are associated with poor prognosis. An immune risk score model was constructed base on eight immune cell types, and the ROC curve showed that the immune risk score model is reliable in predicting the prognosis of patients with osteosarcoma (AUC = 0.724). Besides, a nomogram model base on eight immune cell types was constructed to predict the survival rate of patients with osteosarcoma. Conclusions: TIICs are closely related to the prognosis of osteosarcoma. The immune risk score model based on TIICs is reliable in predicting the prognosis of osteosarcoma. Keywords: Osteosarcoma, TIICs, Prognosis, Immune risk score model, Nomogram
Background Osteosarcoma is a primary malignant bone tumor commonly seen in adolescents and children, with an incidence of 8–11 per million in the 15–19 age group [1–3]. Osteosarcoma is characterized by early lung metastasis and poor prognosis, which seriously threaten the physical and mental health of patients. Currently, chemotherapy along with surgery is the main clinical treatment, * Correspondence: [email protected] 2 Department of Orthopaedic, Hanchuan People’s Hospital, Hanchuan 311200, Hubei Province, China Full list of author information is available at the end of the article
which has improved the prognosis of osteosarcoma. However, recurrence or metastasis remain the poor prognosis [4–7]. Therefore, it is crucial to search for meaningful prognostic biomarker to improve the survival rate of patients. Recent advances in the study of tumor microenvironment (TME) have opened up new directions for the study of osteosarcoma [8, 9]. TME is mainly composed of tumor cells, intercellular matrix, blood vessels and TIICs [10–12]. Recent studies have found a significant correlation between the TIICs in TME and prognosis in cancer patients. For example, in colorectal cancer,
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