An immune-related E2F gene expression signature provides prognostic information in patients with hepatocellular

Background. Hepatocellular carcinoma (HCC) is a fatal form of liver cancer. Through RB-E2F pathway or other mechanisms, E2F transcription factors impact tumorigenesis and progression of multiple cancers including HCC. We aim to develop a prognostic signature based on the expression of E2Fs for HCC patients. Methods. RNA-seq and clinical data from TCGA database were used to identify a prognostic signature based on the expression of E2Fs. Another cohort from GEO database was utilized as external validation. The risk score combined with common clinical factors were employed to establish a nomogram as a clinically-accessible tool. Tumor immune microenvironment influenced by the signature was analyzed and a competing endogenous network of the component genes has been constructed. Results. A prognostic signature dependent on the expression of two E2Fs was developed and validated, with the risk score successfully stratifying HCC patients into different risk groups. A nomogram was provided for clinical application. Patients in the high risk group exhibited significantly higher fractions of immunosuppressive cells than low-risk patients. Moreover, we revealed a mRNA-miRNA-circRNA competing endogenous network that potentially played a pivotal role in the prognosis and progression of HCC. Conclusion. This study offered a novel gene signature that could robustly identify HCC patients with poor survival and highlighted potential predictive biomarkers for therapeutic interventions.