to Evaluate the Tumor Immune Microenvironment and Clinical Prognosis in Glioma.

Background: Previous research indicated that the tumor cells and microenvironment interactions are critical for the immunotherapeutic response. However, predicting the clinical response to immunotherapy remains a dilemma for clinicians. Hence, this study aimed to investigate the associations between expression and prognosis and tumor-infiltrating immune cells in glioma.

Methods: Firstly, we detected the expression in glioma tissues through biological databases. The chi-squared test, Kaplan-Meier, and univariate and multivariate Cox regression analyses were used to analyze the clinical significance of expression. The correlation between expression and levels of tumor-infiltrating immune cells in glioma tissues was investigated. Receiver operating characteristic (ROC) analysis was performed to compare the predictive power between and other commonly immune-related markers.

Results: In the CGGA cohort of 325 glioma patients, we found that was upregulated in glioma, and increased with tumor grade. High expression was prominently associated with unfavorable clinicopathological features, and poorer survival of patients, which were further confirmed by TCGA (n=609) and GEO (n=74) cohorts. Furthermore, multivariate analysis indicated that is an independent prognostic biomarker for glioma. Importantly, overexpression was associated with a higher infiltration level of CD4 T cells, CD8 T cells, B cells, macrophages, and neutrophils in glioma. ROC curves showed that, compared with , , and , presented a higher area under the curve (AUC) value (AUC=0.824) for predicting high immune infiltration levels in glioma.

Conclusions: We found that was upregulated and could act as a poor prognostic biomarker in glioma. Importantly, overexpression was associated with the immune infiltration levels of immune cells including B cells, CD4 T cells, CD8 T cells, macrophages, and neutrophils, and strongly with the overall immune infiltration levels of glioma. These findings suggested that might be a potential biomarker for evaluating prognosis and immune infiltration in glioma.