Identification and Validation of A Hypoxia-Related Prognostic and Immune Microenvironment Signature in Bladder Cancer

Abstract Bladder cancer is the main leading causes of cancer-related deaths and seriously affects population health. Hypoxia plays a key role in tumor development and immune escape, which contributes to malignant behaviors. In this study, we analyzed the RNA-seq and clinical information of bladder cancer patients from The Cancer Genome Atlas (TCGA) database. In order to investigate the hypoxia-related prognostic and immune microenvironment in bladder cancer, we constructed a hypoxia-related risk model for overall survival (OS). Moreover, the RNA-seq and clinical information of bladder cancer patients from Gene Expression Omnibus (GEO) database were used to verified. Our research revealed that the hypoxia risk signature significantly correlated with clinical outcome and independently predict the OS. Furthermore, the hypoxia risk signature could effectively reflect the level of immune cell type fraction and the expression of critical immune checkpoint genes were higher in the high-risk group compare to low-risk group. We also confirmed the expression level of the prognostic genes in bladder cancer and paracancerous tissue samples using qRT-PCR analysis. In summary, the present study identified 7 hypoxia-related genes (HRGs) signature that may be served as an independent clinical predictor and provide a potential mechanism in bladder cancer immunotherapy.