Construction and validation of a nomogram based on N6-Methylandenosine-related lncRNAs for predicting the prognosis of non-small cell lung cancer patients.

Background: The N6-methyladenosine (m A) can modify long non-coding RNAs (lncRNAs), thereby influencing a wide array of biological functions. However, the prognosis of m A-related lncRNAs (m ARLncRNAs) in non-small cell lung cancer (NSCLC) remains largely unknown.

Methods: Pearson correlation analysis was used to identify m ARLncRNAs in 1835 NSCLC patients and with the condition (|Pearson R| > 0.4 and p < 0.001). Univariant Cox regression analysis was conducted to explore the prognostic m ARLncRNAs. We filtered prognostic m ARLncRNAs by LASSO regression and multivariate Cox proportional hazard regression to construct and validate an m ARLncRNAs signature (m ARLncSig). We analyzed the correlation between the m ARLncSig score and clinical features, immune microenvironment, tumor mutation burden, and therapeutic sensitivity and conducted independence and clinical stratification analysis. Finally, we established and validated a nomogram for prognosis prediction in NSCLC patients.

Results: Forty-one m ARLncRNAs were identified as prognostic lncRNAs, and 12 m ARLncRNAs were selected to construct m ARLncSig in the TCGA training dataset. The m ARLncSig was further validated in the testing dataset, GSE31210, GSE37745, GSE30219, and our NSCLC samples. In terms of m ARLncSig, NSCLC patients were divided into high- and low-risk groups, with significantly different overall survival (OS), clinical features (age, sex, and tumor stage), tumor-infiltrating immune cells, chemotherapeutic sensitivity, radiotherapeutic response, and biological pathways. Moreover, m ARLncSig independently predicted the OS of NSCLC patients. Finally, the robustness and clinical practicability for predicting NSCLC patient prognosis was improved by constructing a nomogram containing the m ARLncSig, age, gender, and tumor stage.

Conclusions: Our study demonstrated that m ARLncSig could act as a potential biomarker for evaluating the prognosis and therapeutic efficacy in NSCLC patients.