Prognostic biomarkers for bladder cancer based on differentially expressed exosome-related genes

Background: In cancer, exosomes play an important role in cell-to-cell communication, cancer metastasis,neovascularization, and drug resistance. Due to the lack of mechanistic studies regarding exosomes in bladder cancer (BCa), the goal of this study was to identify the significance of exosome-related genes in BCa. Methods: Differentially expressed genes (DEGs) were analyzed using the Cancer Genome Atlas (TCGA) databases. DEGs closely associated with BCa patient survival were identified using Cox regression, least absolute shrinkage, and selection operator analyses. A prognostic model about exosomes was then developed and validated. To predict survival, a nomogram was developed. Results: A prediction model was constructed using seventeen of the six hundred and fifty-six DEGs related to exosomes. A low-risk and high-risk group was then established for patients with BCa. Patients at high-risk group had a significantly worse prognosis than those at low-risk group. Further analysis showed a lower risk score was associated with higher expression of immune cell infiltration, including T cells regulatory (Tregs) and Mast cells activated, and immune checkpoint genes, including LGALS9 and TNFRSF14. Conclusions: Using exosome-related genes, this study identified a novel biomarker that may be used to predict the outcome of BCa in the future.