Development of a prognostic model for personalized prediction of colon adenocarcinoma (COAD) patient outcomes using methylation-driven genes.

The objective of this study was to identify methylation-driven genes and explore their prognostic value in colon adenocarcinoma (COAD). The Cancer Genome Atlas (TCGA) database was used to acquire collated COAD transcriptome gene expression matrix (containing 59,427 transcripts), transcriptome gene methylation level matrix (containing 29,602 methylated modified genes), which included 517 samples containing 41 samples of normal tissue (NT) & 476 samples of COAD, and patient clinical information files (including patient survival time, survival status, age, gender and tumor stage, etc.), for all COAD samples. A total of 9807 differentially expressed genes (DEGs) were obtained by DEG analysis of the COAD transcriptional expression matrix, of which 5874 were up-regulated and 3933 were down-regulated. And 46 methylation-driven DEGs (MD-DEGs) in COAD were obtained by DEG analysis, differential analysis of gene methylation levels, and correlation analysis between them. Next, three prognostic associated MD-DEGs (PMD-DEGs) (IDUA, ZBTB18 and C5orf38) were identified by Cox regression analysis, and a prognostic model composed of the three PMD-DEGs was constructed by least absolute shrinkage and selection operator (LASSO) regression analysis and cross-validation analysis. In addition, survival analysis, the receiver operating characteristics (ROC) curve analysis and independent prognostic analysis were used to evaluate and verify that the prognostic model we constructed could accurately and independently predict the prognosis of COAD patients. Finally, we constructed a nomogram based on the prognosis model to accurately and personalized predict the survival prognosis of COAD patients. In conclusion, we identified the methylation driver gene of COAD and constructed a prognostic model and nomogram to personalized predict the prognosis of patients, which opened a new prospect for accurate diagnosis and treatment in clinical practice.