Identification of prognostic genes in adrenocortical carcinoma microenvironment based on bioinformatic methods

Figure 1. Lower immune scores significantly associated with malignant progression of ACC Scatter plots revealed the distribution of immune scores in AJCC‐T (P = 0.1573) (A), AJCC‐N (P = 0.0787) (B), AJCC‐M (P = 0.8842) (C), tumor stage (P = 0.0664) (D) and event of malignant progression (P = 0.0204) (E). Lower immune scores were associated with DM and LR than other cases. K‐M survival curve shown that ACC patients with lower immune scores were associated with poor survival outcomes (P = 0.0495) (F). Results of K‐M analysis in stromal score (G) and ESTIMATE score (H) shown no statistical significance (P = 0.3064, P = 0.2210, respectively). DM, distant metastasis; K‐M, Kaplan‐Meier; LR, locoregional recurrence

Figure 2. Comparison of gene expression profiles with immune scores and stromal scores. Based on immune scores, clustering analysis was shown in Heatmap (A). Volcano plot exhibit significantly differentially expressed genes (B). Venn plots revealed 1122 intersect genes which including 907 upregulated genes in higher immune/stromal scores (C) and 215 down‐regulated genes in lowerimmune/stromal scores (D)

Figure 3. Hub genes screened by 12 algorithms from cytoHubba. The network shown the analysis results generated by the algorithms of MCC (A), DMNC (B), MNC (C), Radiality (D), Closeness (E), Degree (F), Betweenness (G), BottleNeck (H), EPC (I), EcCentricity (J), Stress (K) and ClusteringCoefficent (L). The size of the circle indicates the node degree

Figure 4. GO analysis, KEGG analysis and GSEA. Results of BP (A), CC (B), and MF (C) in GO analysis revealed the relationship between hub genes and functional pathways. Pathway annotation (D) and enrichment (E) were revealed by bar charts and top 20 pathway enrichment was shown by bubble chart (F) in KEGG analysis. GSEA analysis (G) was performed to further screen the significant pathway between higher immune scores group and lower immune scores group. The q‐value＜0.05 was considered as significance. BP, biological process; CC, cellular component; GO, geneontology; GSEA, Gene Set Enrichment Analysis; KEGG, Kyoto Encyclopedia of Genes and Genomes; MF, molecular function

Figure 5. Prognostic value of RS. Survival analysis revealed that RS significantly related with poor survival outcomes (A, P＜ 0.0001). ROC curve indicated superior predictive accuracy in survival outcomes (AUC = 0.887) (B). AUC, area under the curve; ROC, receiver operating characteristic curve; RS, risk score

Figure 6. Survival analysis of hub genes. The K‐M curves revealed that 18 hub genes were significantly associated with survival outcomes

Figure 7. Selected hub genes were associated with immune cells infiltration. HLA‐DOA was significantly related with B cell, CD4 T cell, CD8 T cell, macrophage, neutrophil and dendritic cell infiltration (A). Other genes were related with some of the above immune cells infiltration (B‐S)