Prediction of pancreatic adenocarcinoma patient risk status using alternative splicing events

In literature, several mRNA, miRNA, lncRNA based biomarkers are identified by genomic analysis to stratify the patients into high and low risk groups of pancreatic adenocarcinoma (PAAD). The identified biomarkers are of limited use in terms of sensitivity and prediction ability. Thus, we aimed to identify the prognostic alternative splicing events and their related mutations in the PAAD. PAAD splicing data of 174 samples (17874 AS events in 6209 genes) and corresponding clinical information was obtained from the SpliceSeq and The Cancer Genome Atlas (TCGA), respectively. Prognostic-index based modeling was used to obtain the best predictive models for the seven AS types. However, model based on multiple spliced events genes (APP; LATS1; MRPL4; LAS1L; STARD10; PHF21A; NMRAL1) outperformed the single event models with a remarkable HR of 9.13 (p-value = 6.42e-10) as well as other existing models. Results from g:Profiler suggest that transcription factors ZF5, ER81, E2F-1/2/3, ER81, Erg, and PEA3 are most related to the prognostic spliced genes. We also identified 565 mutations across 160 spliced genes that have a strong association with the prognostic AS events. The analysis revealed that around 560 of these mutations were not reported before in context to splice event/region. Overall, we conclude that altered AS events may serve as strong indicators for overall survival in pancreatic cancer patients, and novel linkage of the known mutations to the survival-related AS events may provide a new dimension to the advancement of diagnostic and therapeutic interventions in these patients.