Research Paper Volume 12, Issue 21 pp 21582—21596

Autophagy-related long noncoding RNAs can predict prognosis in patients with bladder cancer

Cong Lai1, *, , Zhenyu Wu1, *, , Juanyi Shi1, , Kaiwen Li1, , Jiamin Zhu1, , Zhenhong Chen1, , Cheng Liu1, , Kewei Xu1, ,

  • 1 Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
* Equal contribution

Received: April 25, 2020       Accepted: August 8, 2020       Published: November 7, 2020
How to Cite

Copyright: © 2020 Lai 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 credited.


We investigated whether autophagy-related long noncoding RNAs (lncRNAs) can predict prognosis in bladder cancer. We obtained bladder cancer lncRNA data from The Cancer Genome Atlas and autophagy-related genes from the Human Autophagy Database. Fifteen autophagy-related lncRNAs with prognostic significance were identified. Multivariate Cox analysis was used to construct a risk score model, which divided bladder cancer patients into high-risk and low-risk groups. We found that patients in the low-risk group had better survival than those in the high-risk group. Subgroup analysis showed that patients in the high-risk group also had worse OS than that in the low-risk group in subgroups based on age, gender, clinical stage, and TNM stage. We next established a nomogram according to the results of multivariate Cox regression, which included age, gender, clinical stage, TNM stage, and risk score. The area under the curve for 3- and 5-year overall survival predicted by the nomogram were 0.711 and 0.719, respectively. Bioinformatics analysis demonstrated that the 15 identified lncRNAs are involved in the cell cycle, DNA replication, cell adhesion, cancer pathway, WNT signaling pathway, and oxidative stress. These findings confirm that autophagy-related lncRNAs are predictive of prognosis in bladder cancer patients and may affect tumor progression.


MIBC: muscle-invasive bladder cancer; LncRNA: long noncoding RNA; ATG: autophagy-related gene; TCGA: The Cancer Genome Atlas; HADb: Human Autophagy Database; FDR: false discovery rate; LASSO: least absolute shrinkage and selection operator; OS: overall survival; ROC: receiver operating characteristic; AUC: area under the curve; DCA: decision curve analysis; GO: Gene Ontology; KEGG: Kyoto Encyclopedia of Genes and Genomes.