Lower Manic Fringe Expression as an Independent Prognostic Biomarker and Correlated with Immune Suppression of Tumor Microenvironment in Lung Adenocarcinoma
Emergency Department, Qingdao Municipal Hospital, Qingdao, Shandong Province 266073, China
Jie Han, Emergency Department, Qingdao Municipal Hospital, Qingdao, Shandong Province 266073, China, E-mail: email@example.com
Non-small cell lung cancer is the leading cause of cancer-associated mortality worldwide and lung adenocarcinoma is its most common type. The fringe protein family can modulate the Notch receptors to regulate pathways and affect a variety of physiological processes, such as embryo development and tumor formation. To investigate the influence of manic fringe expression on the prognosis of lung adenocarcinoma patients and evaluate its correlation with immune suppression of tumor microenvironment is the objective of the study. Wilcoxon rank test and logistic regression were used to analyze the relationship between manic fringe expression and clinical characteristics of patients with lung adenocarcinoma. The influence of manic fringe expression on the prognosis of lung adenocarcinoma patients was analyzed using Kaplan- Meier plotter analysis and Cox regression, and a receiver operating characteristic curve and nomogram were constructed. Single sample gene set enrichment analysis was used to analyze the correlation between manic fringe expression and immune infiltration. The expression of manic fringe in lung adenocarcinoma was verified using the Oncomine and tumor immune estimation resource database. Manic fringe expression in lung adenocarcinoma patients was significantly lower than that in normal lung tissues. Kaplan-Meier plotter analysis revealed that the overall survival and disease-specific survival of lung adenocarcinoma patients with low manic fringe expression were shorter (p<0.05) than those of patients with high expression. Multivariate Cox analysis further confirmed that high manic fringe expression was an independent predictor of longer overall survival in patients with lung adenocarcinoma. Furthermore, the other clinicopathological features, such as tumour and lymph nodes classification and residual tumor R classification, were correlated with worse prognosis. Single sample gene set enrichment analysis showed that manic fringe expression was correlated with infiltration of interdigitating dendritic cells and tumor cells. Manic fringe may be used as an independent prognostic biomarker and is associated with immune infiltration in lung adenocarcinoma.