A Novel RNA-Binding Protein-Based Nomogram for Predicting Survival of Patients with Gastric Cancer

BACKGROUND We attempted to develop a prognostic model and characterize molecular subtypes for gastric cancer on the basis of ribonucleic acid (RNA)-binding proteins (RBPs). MATERIAL AND METHODS RNA sequence data of gastric cancer were obtained from The Cancer Genome Atlas. Univariate Cox regression analysis was used to screen survival-related RBPs, followed by least absolute shrinkage and selection operator Cox modeling. Overall and stratified survival analysis was carried out between high and low risk score groups, followed by receiver operator characteristic curve construction. Univariate and multivariate survival analysis was applied to assess its independent prognostic potential. A nomogram was constructed by combining age and the risk score, which was verified by calibration curves and decision curve analyses for 1-, 3-, and 5-year survival. Molecular subtypes were identified using nonnegative matrix factorization method. Clinical features of the identified subtypes were characterized on prognosis, drug sensitivity, and immune infiltration. An external Gene Expression Omnibus dataset was used to verify the above findings. RESULTS On the basis of 44 survival-related RBPs, a robust prognostic 15-RBP signature was constructed. Patients with high risk score had a poorer prognosis than those with low risk score. The risk score had good performance in predicting clinical outcomes for 1-, 3-, and 5-year survival. The signature was effectively independent of other clinical features. The nomogram model combining age and the 15-RBP prognostic model exhibited better practicality and reliability for prognosis. RBP expression data were utilized to define 2 distinct molecular subtypes obviously related to survival outcomes, chemotherapeutic drug sensitivity, and immune infiltration. CONCLUSIONS Our study provides a nomogram model that consists of age and a 15-RBP signature and identifies 2 molecular subtypes for gastric cancer that possess potential value for preclinical, clinical, and translational research on gastric cancer.