Transcription Elongation Factor A-like 7 is a Stemness-Related Prognostic Factor in Gastric Cancer

Abstract Background: Stemness is described as the potential for self-renewal and differentiation from the cell-of-origin. A previous study calculated the mRNA expression-based stemness index (mRNAsi) based on a one-class logistic regression machine learning algorithm for describing stemness features of cancer. We aim to identify stemness-related prognostic genes in gastric cancer (GC) based on mRNAsi using bioinformatics analysis.Methods: The WGCNA analysis was performed to find the relevant gene modules to mRNAsi. Gene ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathways annotation analysis were performed on genes in blue module. The overall survival analysis, univariate Cox regression analysis and the least absolute shrinkage and selection operator (LASSO) regression model were used to identify prognostic genes highly associated with survival. The multivariate Cox regression analysis was performed to analysis prognostic factors. The nomogram was constructed according to the result of multivariate analysis. qPCR, Western Blot and IHC staining were appliedResults: The mRNAsi of tumors is higher than normal tissues, and there was a significant difference in overall survival (OS) between the high and low mRNAsi GC groups. TCEAL7 was selected to be the key gene associated with mRNAsi and prognosis according to the result of least absolute shrinkage and selection operator (LASSO) Cox regression. The expression level of TCEAL7 was lower in tumors than in normal tissues, but high TCEAL7 level group showed a worse OS than low TCEAL7 level group in GC. Based on the result of multivariable Cox regression analysis which including TCEAL7 and clinical characteristics, a nomogram for predicting GC 1-, 3-, and 5-year survival was established. The C-index and the AUC (Area Under Curve) of the model indicated that the model has a good discrimination ability. Additionally, the calibration curves of 3- and 5-year OS rates showed the model fits well. The experimental validation of the expression of TCEAL7 in GC and normal tissues were consistent with the above.Conclusions: In summary, we verified mRNAsi was associated with the prognosis of GC patients. And TCEAL7 was finally identified as the key gene correlated with stemness features and prognosis in GC.