A novel five-zinc finger-related-gene signature related to tumor immune microenvironment allows for treatment stratification and predicts prognosis in clear cell renal cell carcinoma patients

Abstract Background Clear cell renal cell carcinoma (ccRCC) is one of the most prevalent renal malignant tumors, which survival rate and quality of life of ccRCC patients are not satisfactory. Therefore, identification of prognostic biomarkers of ccRCC patients will contribute to early and accurate clinical intervention and treatment, and then improve their prognosis. Methods We downloaded the original expression data of mRNAs from The Cancer Genome Atlas database and the zinc finger(ZNF)-related genes (ZRGs) from UniProt online database. Differentially expressed ZRGs (DE-ZRGs) was screened from tumor and adjacent nontumor tissues and functional enrichment analysis was conducted out. A five-ZRG signature were constructed by univariate Cox regression, least absolute shrinkage and selection operator and multivariate Cox regression. Furthermore, we screened out independent prognosis-related factors to build a nomogram by univariate and multivariate Cox regression. Potential biological pathways of five ZRGs were analyzed by Gene Set Enrichment Analysis (GSEA). Then, we further quantitatively analyze immune infiltration and evaluate tumor microenvironment by single sample GSEA. Finally, drug sensitivity of ccRCC patients was analyzed by the Genomics of Drug Sensitivity in Cancer database. Results TRIM59, VAV3, ZNF189, AGAP9 and PYGO1 were screened to be significantly associated with the prognosis of ccRCC patients. Through incorporated risk score and clinical parameters, we constructed a nomogram, which showed a good prognostic performance for ccRCC patients.