Development and Validation of an Immunotherapy-Related Prognostic Signature Based on Lymph Node Ratio for Gastric Cancer

Background. The long-term prognosis of gastric cancer (GC) remains poor due to postoperative recurrence and metastasis. increasing evidence show that the lymph node ratio (LNR) serves as an independent prognostic factor in patients with GC. In this study, we aimed develop a signature for GC based on LNR. Methods. Survival analysis was conducted by comparing low- high-LNR groups according optimal cutoff value LNR, which identified receiver operating characteristic (ROC) curve analysis. Then, differentially expressed genes (DEGs) related LNR training cohort Univariate Cox regression least absolute shrinkage selection operator (LASSO) were performed construct risk score signature. We then evaluated from viewpoints survival, clinic-pathological characteristics, tumor microenvironment (TME), mutation burden (TMB), immunotherapeutic chemotherapeutic efficacy. Results. High significantly correlated poorer predictor eleven-gene could predict developed LNR-related DEGs cohort, results further confirmed external cohort. addition, high-risk group showed aggressive clinicopathological specific TME status, low TMB, sensitivity. Conclusions. present study constructed facilitate development individualized treatment strategy.