Identification and validation of a hypoxia- and immune-related prognostic signature for pancreatic cancer

Pancreatic cancer is a lethal disease with a poor prognosis. Immunity and hypoxia are critical characteristics of the tumor microenvironment and are closely associated with cancer prognosis. The present study aimed to identify a novel hypoxia- and immune-related gene signature for the prediction of prognosis in patients with pancreatic cancer. The status of hypoxia or immunity was determined via the NMF method by using data from the TCGA database. A total of 27 hypoxia- or immune-related DEGs were identified. A 6-gene hypoxia- and immune-related prognostic signature (GALR2, AGT, MAPT, PRKCG, CAMK2B and PKP1) was further identified via LASSO regression. Survival analysis revealed that the overall survival of patients with pancreatic cancer was inversely associated with the prognostic signature. A ROC curve indicated the excellent performance of the prognostic signature, with an AUC of 0.713. A similar prognostic value of the prognostic signature was further confirmed in 2 independent GEO cohorts. In addition, a nomogram was constructed with the prognostic signature and clinical factors, including sex, age and histological grade, and the performance of the nomogram was assessed via calibration plots and decision curve analysis. Thus, our study identified a hypoxia- and immune-related prognostic signature and established a nomogram, which may be helpful for survival prediction in patients with pancreatic cancer.