Wu Tong, Qian Tian-Yang, Lin Ren-Jie, Jin Dan-Dan, Xu Xue-Bin, Huang Meng-Xiang, Ji Jie, Jiang Feng, Pan Ling-Ling, Luo Lan, Ji Yi-Fei, Chen Qiao-Lan, Xiao Ming-Bing
Department of Gastroenterology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, China.
First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
J Gastrointest Oncol. 2022 Oct;13(5):2553-2564. doi: 10.21037/jgo-22-941.
Both N6-methyladenosine (m6A) ribonucleic acid (RNA) methylation and ferroptosis regulators are demonstrated to have significant effects on the malignant clinicopathological characteristics of pancreatic adenocarcinoma (PAAD) patients. However, the currently available clinical indexes are not sufficient to predict precise prognostic outcomes pf PAAD patients accurately. This study aims to examine the clinicopathologic features of m6A RNA methylation and ferroptosis regulators in predicting the outcomes of different types of cancer.
As the foundation for this research, the differentially expressed genes (DEGs) between PAAD tissues and adjacent normal tissues were first identified. Next, dimensional reduction analysis (DCA) based on m6A RNA methylation regulators and ferroptosis regulators were performed and DEGs between good/poor prognosis PAAD patient clusters were identified. DEGs were then screened by Cox analysis, and finally a risk signature was established by least absolute shrinkage and selection operator (LASSO) analyses. The prediction model based on risk score was further evaluated by a validation set from Gene Expression Omnibus (GEO) database.
In total, 4 m6A RNA methylation regulator genes and 29 ferroptosis regulator genes were found to have close causal relationships with the prognosis of PAAD, and a risk score with 3 m6A methylation regulators (i.e., , and ) and 4 ferroptosis regulators (i.e., , , , and ) was constructed and showed to be highly involved in PAAD progression and could serve as effective markers for prognosis with AUC value equaled 0.753 in training set and 0.803 in validation set.
The combined prediction model, composed of seven regulators of m6A methylation and ferroptosis, in this study more effectively reflects the progression and prognosis of PAAD than previous single genome or epigenetic analysis. Our study provides a broader perspective for the subsequent establishment of prognostic models and the patients may benefit from more precision management.
N6-甲基腺苷(m6A)核糖核酸(RNA)甲基化和铁死亡调节因子均被证明对胰腺腺癌(PAAD)患者的恶性临床病理特征有显著影响。然而,目前可用的临床指标不足以准确预测PAAD患者的精确预后结果。本研究旨在探讨m6A RNA甲基化和铁死亡调节因子的临床病理特征在预测不同类型癌症预后中的作用。
作为本研究的基础,首先鉴定PAAD组织与相邻正常组织之间的差异表达基因(DEG)。接下来,基于m6A RNA甲基化调节因子和铁死亡调节因子进行降维分析(DCA),并鉴定预后良好/不良的PAAD患者簇之间的DEG。然后通过Cox分析筛选DEG,最后通过最小绝对收缩和选择算子(LASSO)分析建立风险特征。基于风险评分的预测模型通过来自基因表达综合数据库(GEO)的验证集进一步评估。
总共发现4个m6A RNA甲基化调节基因和29个铁死亡调节基因与PAAD的预后密切相关,并构建了一个包含3个m6A甲基化调节因子(即 、 和 )和4个铁死亡调节因子(即 、 、 和 )的风险评分,该评分显示与PAAD进展高度相关,可作为有效的预后标志物,训练集中的AUC值为0.753,验证集中的AUC值为0.803。
本研究中由7个m6A甲基化和铁死亡调节因子组成的联合预测模型比以往的单基因组或表观遗传学分析更有效地反映了PAAD的进展和预后。我们的研究为后续预后模型的建立提供了更广阔的视角,患者可能会从更精准的管理中受益。