Research Paper Volume 12, Issue 15 pp 15624—15637

An autophagy-related long non-coding RNA prognostic signature accurately predicts survival outcomes in bladder urothelial carcinoma patients

Zhuolun Sun1,3, , Changying Jing2,3, , Chutian Xiao1, , Tengcheng Li1, ,

  • 1 Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
  • 2 The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
  • 3 Equal contribution

Received: April 30, 2020       Accepted: July 6, 2020       Published: August 15, 2020
How to Cite

Copyright © 2020 Sun et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are cited.


In this study, we analyzed the prediction accuracy of an autophagy-related long non-coding RNA (lncRNA) prognostic signature using bladder urothelial carcinoma (BLCA) patient data from The Cancer Genome Atlas (TCGA) database. Univariate and multivariate Cox regression analyses showed significant correlations between five autophagy-related lncRNAs, LINC02178, AC108449.2, Z83843.1, FAM13A-AS1 and USP30−AS1, and overall survival (OS) among BCLA patients. The risk scores based on the autophagy-related lncRNA prognostic signature accurately distinguished high- and low-risk BCLA patients that were stratified according to age; gender; grade; and AJCC, T, and N stages. The autophagy-related lncRNA signature was an independent prognostic predictor with an AUC value of 0.710. The clinical nomogram with the autophagy-related lncRNA prognostic signature showed a high concordance index of 0.73 and accurately predicted 1-, 3-, and 5-year survival times among BCLA patients in the high- and low-risk groups. The lncRNA-mRNA co-expression network contained 77 lncRNA-mRNA links among 5 lncRNAs and 49 related mRNAs. Gene set enrichment analysis showed that cancer- and autophagy-related pathways were significantly enriched in the high-risk group, and immunoregulatory pathways were enriched in the low-risk group. These findings demonstrate that an autophagy-related lncRNA signature accurately predicts the prognosis of BCLA patients.


AJCC: The American Joint Committee on Cancer; AUC: area under the curve; BLCA: bladder urothelial carcinoma; C-index: concordance index; GO: Gene Ontology; GSEA: Gene Set Enrichment Analysis; HADb: The Human Autophagy Database; HR: hazard ratio; KEGG: Kyoto Encyclopedia Of Genes And Genomes; LncRNA: long non-coding RNA; OS: overall survival; PCA: principal component analysis; ROC: receiver operating characteristic; TCGA: The Cancer Genome Atlas.