Construction of a lymphangiogenesis related gene score signature and prognostic model for bladder cancer

Abstract Background : Lymph node metastasis is an important prognostic factor for bladder cancer patients, and the critical importance of lymphangiogenesis as an elemental process of metastasis has been reported. However, the effect of lymphangiogenesis genes on the prognosis of bladder cancer is still unclear. Method: The gene expression and clinical data of bladder cancer patients were obtained from the TCGA database, and lymphangiogenesis-related genes were screened using univariate Cox regression analysis and LASSO analysis to construct a risk assessment model. The model was validated in the bladder cancer cohort patients in the GEO database. Finally, multi-omics analysis was performed to explore the predictive value of the model, and the transcriptional regulatory mechanism of related genes. Results： We screened 17 lymphangiogenesis-related genes and established a risk score model for predicting survival in BCa patients. Better overall survival was observed in the low-risk group of both the training and test groups. A nomogram was developed to predict the survival outcomes of postoperative patients by integrating several clinical factors, and a well-predictive effect was observed. In addition, we performed drug sensitivity analysis to learn the chemosensitivity of each sample, assessed the relationship between the model and the immune microenvironment, and explored the specific signaling pathways involved in the prognostic model through enrichment analyses. Conclusion: We developed a risk model using 17 lymphangiogenesis-related genes, which showed good predictive efficacy among both the internal and external validation groups. The clinical predictive value of the model was also explored in a multi-omics study.