Predicting prognosis of endometrioid endometrial adenocarcinoma on the basis of gene expression and clinical features using Random Forest

Traditional clinical features are not sufficient to accurately judge the prognosis of endometrioid endometrial adenocarcinoma (EEA). Molecular biological characteristics and traditional clinical features are particularly important in the prognosis of EEA. The aim of the present study was to establish a predictive model that considers genes and clinical features for the prognosis of EEA. The clinical and RNA sequencing expression data of EEA were derived from samples from The Cancer Genome Atlas (TCGA) and Peking University People's Hospital (PKUPH; Beijing, China). Samples from TCGA were used as the training set, and samples from the PKUPH were used as the testing set. Variable selection using Random Forests (VSURF) was used to select the genes and clinical features on the basis of TCGA samples. The RF classification method was used to establish the prediction model. Kaplan-Meier curves were tested with the log-rank test. The results from this study demonstrated that on the basis of TCGA samples, 11 genes and the grade were selected as the input features. In the training set, the out-of-bag (OOB) error of RF model-1, which was established using the ‘11 genes’, was 0.15; the OOB error of RF model-2, which was established using the ‘grade’, was 0.39; and the OOB error of RF model-3, established using the ‘11 genes and grade’, was 0.15. In the testing set, the classification accuracy of RF model-1, model-2 and model-3 was 71.43, 66.67 and 80.95%, respectively. In conclusion, to the best of our knowledge, the VSURF was used to select features relevant to EEA prognosis, and an EEA predictive model combining genes and traditional features was established for the first time in the present study. The prediction accuracy of the RF model on the basis of the 11 genes and grade was markedly higher than that of the RF models established by either the 11 genes or grade alone.