Gene pair based prognostic signature for colorectal colon cancer

Background: The identification of high-risk colorectal cancer (CRC) patient is key to individualized treatment after surgery and reliable prognostic biomarkers are needed identifying high-risk CRC patients. Methods: We developed a gene pair based prognostic signature that could can the prognosis risk in patients with CRC. This study retrospectively analyzed 4 public CRC datasets, and 1123 patients with CRC were divided into a training cohort (n= 300) and 3 independent validation cohorts (n= 507, 226, and 90 patients). Results: A signature of 9 prognosis-related gene pairs (PRGPs) consisting of 17 unique genes was constructed. Then, a PRGP index (PRGPI) was constructed and divided patients into high-and low-risk groups according to the signature score. Patients in the high-risk group showed a poorer relapse-free survival than the low-risk group in both the training cohort [ hazard ratio (HR) range, 4.6, 95% confidence interval (95% CI), 2.55-8.32; P<. 0001] and meta-validation set (hazard ratio range, 4.09, 95% CI, 1.99-8.39; P<. 0001). The PRGPI signature achieved a higher accuracy [ mean concordance index (C-index): 0.6 0.74] than a commercialized molecular signature (mean C-index, 0.48 0.56) for estimation of relapse-free survival in comparable validation sets. Conclusion: The gene pair based prognostic signature is a promising biomarker for estimating relapse-free survival of CRC.