背景：肾母细胞瘤（WT）是儿童最常见的原发性肾脏恶性肿瘤。自噬在促进和抑制各种癌症中起着双重作用。
目的：我们研究的目的是开发一种新的自噬相关基因（ARG）WT预后列线图。
方法：使用癌症基因组图谱（TCGA）数据库。我们筛选了136名WT患者的ARGs表达谱。通过多变量Cox回归分析和生存分析评估差异表达的预后ARGs。使用多变量Cox回归分析，建立了一个基于ARGs和临床特征的新的预后列线图。
结果：首先，在WT患者中鉴定出69个差异表达的ARGs。然后，使用多变量Cox回归分析来确定WT4个关键的预后ARG（CC3CL1、ERBB2、HIF-α和CXCR4）。根据它们的ARG表达水平，将患者分为高风险组和低风险组。其次，生存分析表明，高风险患者的总体生存率明显低于低风险患者。功能富集分析的结果表明，自噬可能在WT的发生中发挥肿瘤抑制作用。最后，通过整合临床特征和4-ARG特征，使用Harrell一致性指数（C指数）为0.841的预后列线图来预测WT患者的生存概率。校准曲线表明其具有优异的预测性能。
结论：总之，ARG信号可能是监测WT预后的一种很有前途的生物标志物。我们基于ARG信号建立了一种新的列线图，它可以准确预测WT患者的总生存率。
ackground: Wilms Tumor (WT) is the most common primary renal malignancy in children. Autophagy plays dual roles in the promotion and suppression of various cancers.

Objective: The goal of our study was to develop a novel autophagy-related gene (ARG) prognostic nomogram for WT.

Methods: The Cancer Genome Atlas (TCGA) database was used. We screened the expression profiles of ARGs in 136 WT patients. The differentially expressed prognostic ARGs were evaluated by multivariate Cox regression analysis and survival analysis. A novel prognostic nomogram based on the ARGs and clinical characteristics was established using multivariate Cox regression analysis.

Results: First, 69 differentially expressed ARGs were identified in WT patients. Then, multivariate Cox regression analysis was used to determine 4 key prognostic ARGs (CC3CL1, ERBB2, HIF-α and CXCR4) in WT. According to their ARG expression levels, the patients were clustered into high- and low-risk groups. Next, survival analysis indicated that high-risk patients had significantly poorer overall survival than low-risk patients. The results of functional enrichment analysis suggested that autophagy may play a tumor-suppressive role in the initiation of WT. Finally, a prognostic nomogram with a Harrell's concordance index (C-index) of 0.841 was used to predict the survival probability of WT patients by integrating clinical characteristics and the 4-ARG signature. The calibration curve indicated its excellent predictive performance.

Conclusion: In summary, the ARG signature could be a promising biomarker for monitoring the outcomes of WT. We established a novel nomogram based on the ARG signature, which accurately predicts the overall survival of WT patients.

https://www.ingentaconnect.com/content/ben/cchts/2022/00000025/00000008/art00017