Construct a prognostic model based on fatty acid metabolism/ferroptosis-related genes and reveal the immune heterogeneity and somatic mutation specificity of rectal adenocarcinoma in different groups

Abstract

Abstract Background: The prognosis of late stage rectal adenocarcinoma (READ) patients is poor and the recurrence rate is high. The aim of this research is to explore the prognostic value and underlying molecular mechanism of genes related to fatty acid metabolism/ferroptosis in READ. Methods: All data and clinical information were obtained by accessing public databases. A risk model was constructed based on fatty acid metabolism/ferroptosis-related genes by LASSO algorithm and Cox regression analysis. Then, relationship between the risk score and various clinical characteristics was analyzed. Subsequently, a nomogram was constructed to assess survival. The characteristics of immune microenvironment and somatic mutations in different groups were also investigated. Results: A risk score constructed based on 6 fatty acid metabolism/ferroptosis-related genes was found to be independent prognostic factors of READ and was also associated with disease progression. According to the Kaplan-Meier analysis, the overall survival of READ in the high-risk group score was lower. Moreover, the risk model has high predictive value and good predictive capacity in predicting the long-term prognosis of READ. Immune heterogeneity and somatic mutation specificity were also found in different risk groups. Immunotherapy could potentially provide greater benefits for the high-risk group. Conclusion: Explored the prognostic value and potential mechanism of genes related to fatty acid metabolism/ferroptosis in READ, which is helpful to deepen the understanding of the pathological mechanism of patients and lay a theoretical foundation for subsequent research and treatment.