Immune Microenvironment Signatures as Biomarkers to Predict Early Recurrence of Stage Ia-b Lung Cancer

Qiang Wang; Danting Zhou; Fang Wu; Qingchun Liang; Qiongzhi He; Muyun Peng; Tianyu Yao; Yan Hu; Banglun Qian; Jingqun Tang; Xiang Wang; Wenliang Liu; Fenglei Yu; Chen Chen

doi:10.3389/fonc.2021.680287

Immune Microenvironment Signatures as Biomarkers to Predict Early Recurrence of Stage Ia-b Lung Cancer

Front Oncol. 2021 Jul 28:11:680287. doi: 10.3389/fonc.2021.680287. eCollection 2021.

Authors

Qiang Wang^{1

2}, Danting Zhou^{1

2}, Fang Wu³, Qingchun Liang⁴, Qiongzhi He⁵, Muyun Peng^{1

2}, Tianyu Yao^{1

2}, Yan Hu^{1

2}, Banglun Qian^{1

2}, Jingqun Tang^{1

2}, Xiang Wang^{1

2}, Wenliang Liu^{1

2}, Fenglei Yu^{1

2}, Chen Chen^{1

2}

Affiliations

¹ Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China.
² Hunan Key Laboratory of Early Diagnosis and Precise Treatment of Lung Cancer, The Second Xiangya Hospital of Central South University, Changsha, China.
³ Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, China.
⁴ Department of Pathology, The Second Xiangya Hospital of Central South University, Changsha, China.
⁵ Geneplus-Beijing Institute, Beijing, China.

Abstract

Introduction: Approximately 30% of patients diagnosed with stage Ia-b NSCLC die of recurrent disease after surgery. This study aimed to identify immune-related biomarkers that might predict tumor recurrence in stage Ia-b NSCLC within 40 months after curative resection.

Methods: Gene expression data of stage Ia-b NSCLC samples was retrieved from the TCGA database, the GEO databases, and the Second Xiangya hospital (XXEYY) database. 22 types of tumors infiltrating immune cells and the expression of immune-associated genes were investigated using CIBERSORT, immunohistochemical staining, and GSEA analyses in a total of 450 patients (80 in the training cohort and 370 in the validation cohorts). Recurrence-related immune features were selected based on the LASSO Cox regression model.

Results: High density of Tregs, Macrophages M0 and M1 cell could be observed in recurrence group while the memory B cell was more frequently enriched in controls, yet Tregs alone was significantly associated with tumor early recurrence in TCGA cohort, XYEYY cohort and GSE37745 dataset. A handful of immune-related genes were identified in the recurrence group. Based on Lasso regression analysis, the expressions of five immune-related genes, RLTPR, SLFN13, MIR4500HG, HYDIN and TPRG1 were closely correlated with tumor early recurrence. In the training cohort (TCGA), the combination of these five genes has sensitivity and specificity of 85% and 85%, with AUC of 0.91 (95% CI 0.84-0.98) for lung cancer early recurrence prediction, whereas in validation cohorts, the sensitivity and specificity using this panel was 61-89% and 54-82%, with AUC of 0.62-0.84.

Conclusion: Our study demonstrated that the immune microenvironment signatures were closely related to tumor early recurrence. Compared to tumor-infiltrating lymphocytes, the expression of five immune-related genes could be robust biomarkers to predict early recurrence of stage Ia-b NSCLC after curative resection.

Keywords: TILs (tumor-infiltrating lymphocytes); biomarker; gene expression; lung cancer; recurrence.