A novel risk score model based on five angiogenesis-related long non-coding RNAs for bladder urothelial carcinoma

Radiogenomics uncovers an interplay between angiogenesis and clinical outcomes in bladder cancer

BACKGROUND

Precision medicine has become a promising clinical treatment strategy for various cancers, including bladder cancer, where angiogenesis plays a critical role in cancer progression. However, the relationship between angiogenesis, immune cell infiltration, clinical outcomes, chemotherapy, and targeted therapy remains unclear.

METHODS

We conducted a comprehensive evaluation of angiogenesis-related genes (ARGs) to identify their association with immune cell infiltration, transcription patterns, and clinical outcomes in bladder cancer. An ARG score was constructed to identify angiogenic subgroups in each sample and we evaluated their predictive performance for overall survival rate and treatment response. In addition, we optimized existing clinical detection protocols by performing image data processing.

RESULTS

Our study revealed the genomic-level mutant landscape and expression patterns of ARGs in bladder cancer specimens. Using analysis, we identified three molecular subgroups where ARG mutations correlated with patients' pathological features, clinical outcomes, and immune cell infiltration. To facilitate clinical applicability, we constructed a precise nomogram based on the ARG score, which significantly correlated with stem cell index and drug sensitivity. Finally, we proposed the radiogenomics model, which combines the precision of genomics with the convenience of radiomics.

CONCLUSION

Our study sheds light on the prognostic characteristics of ARGs in bladder cancer and provides insights into the tumor environment's characteristics to explore more effective immunotherapy strategies. The findings have significant implications for the development of personalized treatment approaches in bladder cancer and pave the way for future studies in this field.

An Overview of Angiogenesis in Bladder Cancer

PURPOSE OF THE REVIEW

Angiogenesis plays a key role in bladder cancer (BC) pathogenesis. In the last two decades, an increasing number of publications depicting a multitude of novel angiogenic molecules and pathways have emerged. The growing complexity necessitates an evaluation of the breadth of current knowledge to highlight key findings and guide future research.

RECENT FINDINGS

Angiogenesis is a dynamic biologic process that is inherently difficult to assess. Clinical assessment of angiogenesis in BCs is advancing with the integration of image analysis systems and dynamic contrast-enhanced and magnetic resonance imaging (DCE-MRI). Tumour-associated macrophages (TAMs) significantly influence the angiogenic process, and further research is needed to assess their potential as therapeutic targets. A rapidly growing list of non-coding RNAs affect angiogenesis in BCs, partly through modulation of vascular endothelial growth factor (VEGF) activity. Vascular mimicry (VM) has been repeatedly associated with increased tumour aggressiveness in BCs. Standardised assays are needed for appropriate identification and quantification of VM channels. This article demonstrates the dynamic and complex nature of the angiogenic process and asserts the need for further studies to deepen our understanding.

Vascular Enlargement as a Predictor of Nodal Involvement in Bladder Cancer

In bladder cancer (BC), the evaluation of lymph node (LN) involvement at preoperative imaging lacks specificity. Since neoangiogenesis is paired with lymphatic involvement, this study aims to evaluate the presence of perivesical venous ectasia as an indirect sign of LN involvement, together with other conventional CT findings. All the patients who underwent radical cystectomy (RC) for BC between January 2017 and December 2019 with available preoperative contrast-enhanced CT (CECT) within 1 month before surgery were included. Patients without available pathological reports (and pTNM stage) or who underwent neoadjuvant treatments and palliative RC were excluded. Two readers in blind assessed the nodal shape and hilum, the short axis, and the contrast enhancement of suspicious pelvic LNs, the Largest Venous Diameter (LVD) efferent to the lesion, and the extravesical tumor invasion. In total, 38 patients (33 males) were included: 17 pT2, 17 pT3, 4 pT4; pN+: 20/38. LN short axis > 5 mm, LN enhancement, and LVD > 3 mm were significantly correlated with N+ at pathology. LVD > 3 mm had a significantly higher sensitivity and specificity (≥90%, AUC = 0.949) and was an independent predictor (p = 0.0016).

Identification of platinum resistance-related gene signature for prognosis and immune analysis in bladder cancer

Purpose: Currently, there is limited knowledge about platinum resistance-related long non-coding RNAs (lncRNAs) in bladder cancer. We aim to identify platinum resistance-related lncRNAs and construct a risk model for accurate prognostic prediction of bladder cancer. Methods: Transcriptomic and clinical data were extracted from The Cancer Genome Atlas (TCGA) database, and platinum resistance-related genes were obtained from HGSOC-Platinum. The platinum resistance-related lncRNAs were obtained by the Spearman correlation analysis. Then, we constructed a risk score model through Cox regression analysis and the LASSO algorithm. The model was verified by analyzing the median risk score, Kaplan-Meier curve, receiver operating characteristic (ROC) curve, and heatmap. We also developed a nomogram and examined the relationship between the risk score model, immune landscape, and drug sensitivity. Lastly, we assessed the differential expression of PRR-lncRNAs in the cisplatin-resistant bladder cancer cell line and the normal bladder cancer cell line using qRT-PCR. Results: We developed and validated an eight-platinum resistance-related lncRNA risk model for bladder cancer. The risk model showed independent prognostic significance in univariate and multivariate Cox analyses. Based on multivariate analysis, we developed a nomogram. The modified model is both good predictive and clinically relevant after evaluation. Furthermore, immune-related and drug-sensitivity analyses also showed significant differential expression between high and low-risk groups. The qRT-PCR demonstrated that most of the lncRNAs were upregulated in cisplatin-resistance cancerous tissues than in control tissues. Conclusion: We have developed a predictive model based on eight platinum resistance-related lncRNAs, which could add meaningful information to clinical decision-making.

Identification and validation of a novel angiogenesis-related gene signature for predicting prognosis in gastric adenocarcinoma

Background

Angiogenesis is a major promotor of tumor progression and metastasis in gastric adenocarcinoma (STAD). We aimed to develop a novel lncRNA gene signature by identifying angiogenesis-related genes to better predict prognosis in STAD patients.

Methods

The expression profiles of angiogenesis-related mRNA and lncRNA genes were collected from The Cancer Genome Atlas (TCGA). Then, the "limma" package was used to identify differentially expressed genes (DEGs). The expression profiles of angiogenesis-related genes were clustered by consumusclusterplus. The Pearson correlation coefficient was further used to identify lncRNAs coexpressed with angiogenesis-related clustere genes. We used Lasso Cox regression analysis to construct the angiogenesis-related lncRNAs signature. Furthermore, the diagnostic accuracy of the prognostic risk signature were validated by the TCGA training set, internal test sets and external test set. We used multifactor Cox analysis to determine that the risk score is an independent prognostic factor different from clinical characteristics. Nomogram has been used to quantitatively determine personal risk in a clinical environment. The ssGSEA method or GSE176307 data were used to evaluate the infiltration state of immune cells or predictive ability for the benefit of immunotherapy by angiogenesis-related lncRNAs signature. Finally, the expression and function of these signature genes were explored by RT-PCR and colony formation assays.

Results

Among angiogenesis-related genes clusters, the stable number of clusters was 2. A total of 289 DEGs were identified and 116 lncRNAs were screened to have a significant coexpression relationship with angiogenic DEGs (P value<0.001 and |R| >0.5). A six-gene signature comprising LINC01579, LINC01094, RP11.497E19.1, AC093850.2, RP11.613D13.8, and RP11.384P7.7 was constructed by Lasso Cox regression analysis. The multifactor Cox analysis and Nomogram results showed that our angiogenesis-related lncRNAs signature has good predictive ability for some different clinical factors. For immune, angiogenesis-related lncRNAs signature had the ability to efficiently predict infiltration state of 23 immune cells and immunotherapy. The qPCR analysis showed that the expression levels of the six lncRNA signature genes were all higher in gastric adenocarcinoma tissues than in adjacent tissues. The functional experiment results indicated that downregulation of the expression of these six lncRNA signature genes suppressed the proliferation of ASG and MKN45 cells.

Conclusion

Six angiogenesis-related genes were identified and integrated into a novel risk signature that can effectively assess prognosis and provide potential therapeutic targets for STAD patients.

An angiogenesis‑related lncRNA signature for the prognostic prediction of patients with bladder cancer and LINC02321 promotes bladder cancer progression via the VEGFA signaling pathway

The mechanism underlying bladder cancer metastasis is associated with tumor angiogenesis. The present study aimed to evaluate the predictive role and value of an angiogenesis‑associated long non‑coding (lnc)RNA signature in patients with bladder cancer and the role of long intergenic non‑coding RNA (LINC)02321 in the progression of this malignancy. Angiogenesis‑related lncRNAs were screened using Pearson correlation analysis and the signaturewas constructed using Cox regression analysis and evaluated using the receiver operating characteristic curve. LINC02321, which expressed the largest difference in bladder cancer, was screened using reverse transcription‑quantitative PCR. The role of LINC02321 in the malignant progression of bladder cancer was evaluated using Transwell, wound healing and Cell Counting Kit 8 assays. A total of six angiogenesis‑associated lncRNAs (USP30‑AS1, LINC02321, PSMB8‑AS1, KRT7‑AS, LINC01767 and OCIAD1‑AS1) were identified as candidates for the prognostic signature using Cox regression analysis. The overall survival of patients in the low‑risk group was significantly longer compared with that in the high‑risk group, with the highest area under the curve value being 0.807. A nomogram was constructed based on the traditional clinical indicators (age, sex, grade, American Joint Committee on Cancer stage) and risk score of patients. Compared with the traditional clinical indicators, the risk score demonstrated better clinical prediction capacity for predicting the prognosis of patients with bladder cancer. The Cancer Genome Atlas prediction and RT‑qPCR experimental results demonstrated that only LINC02321 was highly expressed in bladder cancer tissue and promoted the proliferation, invasion, migration and cisplatin resistance of the malignancy. Gene set enrichment, Pearson's correlation analysis and experimental results demonstrated that the VEGFA signalling pathway may be involved in the LINC02321‑regulated progression of bladder cancer. In conclusion, the six angiogenesis‑associated lncRNA signatures reported in the present study may be used to predict the prognosis of patients with bladder cancer, and LINC02321 promoted malignant progression of bladder cancer via the VEGFA signalling pathway.

A novel risk score model based on four angiogenesis long non-coding RNAs for prognosis evaluation of pancreatic adenocarcinoma

BACKGROUND

Long non-coding RNAs (lncRNAs) have been reported to play significant roles in tumour angiogenesis which prominently facilitates pancreatic adenocarcinoma (PAAD) progression.

METHODS

The clinical PAAD data were obtained from TCGA database and clinical specimens of 122 PAAD patients. The Molecular Signatures Database v4.0 was used to identify angiogenesis-related long non-coding RNAs (ARLNRs). Survival-related ARLNRs (sARLNRs) were further validated by univariate and multivariate COX regression analyses. The expressions of CASC8, AC015660.1, Z97832.2 and PAN3-AS1 in PAAD cell lines and tissues were examined by qPCR. The correlations between sARLNRs (CASC8 and AC015660.1) and clinicopathological characteristics of the 122 PAAD patients were analyzed by the chi-square test and Fisher's exact probability method.

RESULTS

590 lncRNAs were identified as ARLNRs, of which four sARLNRs were further used to establish an angiogenesis-related risk score model (ARRS), by which patients in the low-risk group have better survival probabilities than those in the high-risk group. The expression levels of CASC8 and AC015660.1 were significantly higher in PAAD cell lines and tumor tissues especially in patients with advanced grades and T-stages, while Z97832.2 and PAN3-AS1 were inverse. In addition, the higher expression of CASC8 and AC015660.1 prominently associated with the larger tumour size, and the more advanced grade and T-stage. However, the relevance between the sARLNRs (CASC8 and AC015660.1) expression and lymph node metastasis status was not significant.

CONCLUSIONS

In the study, we illuminate the clinical significance, angiogenesis relevance and prognosis-predictive value of four sARLNRs for PAAD. The results build a bridge between sARLNRs and tumour vascularization, and also establish a reliable and accurate risk scoring model for PAAD antiangiogenic strategy.