Identification of Metastasis-Related Signature For Predicting Survival In Osteosarcoma

Background: RNA sequencing has become a powerful tool for exploring tumor recurrence or metastasis mechanisms. In this study, we aimed to develop a signature to improve the prognostic predictions of osteosarcoma. Materials: and methods By comparing the expression profiles between metastatic and non-metastatic samples, we obtained 57 metastatic-related gene signatures. Then we constructed a 3‐gene signature to predict the prognostic risk of osteosarcoma patients by the Cox proportional hazards regression model. The risk score derived from this signature could successfully stratify osteosarcoma patients into subgroups with different survival outcomes. Results: Patients in the low-risk group showed more prolonged overall survival than those in the high-risk group. And the performance was validated with another independent dataset. Multivariate cox regression revealed that the risk score served as an independent risk factor. Besides, we found that patients with low-risk scores had higher expression levels of immune-related signatures, suggesting an active immune status in those patients. Using the CIBERSORT database, we further systematically analyzed the relationships between the risk score and immune cell infiltration levels, as well as the immune activation markers. Higher infiltration of immune cells (CD8 T cells, monocytes, M2 macrophages, and memory B cells) and higher levels of immune cytotoxic markers (GZMA, GMZB, IFNG, and TNF) were observed in patients in the low-risk group. Conclusions: In summary, this 3-gene signature could be a reliable marker for prognostic evaluation and help clinicians identify high‐risk patients.