Wang Zhikai, Zhao Chunyan, Huang Yifen, Li Chong
Department of Gastrointestinal Surgery, Henan Provincial People's Hospital, Zhengzhou, China.
Department of Oncology, The Affiliated Dazu's Hospital of Chongqing Medical University, Chongqing, China.
Biomol Biomed. 2025 Jul 2. doi: 10.17305/bb.2025.12053.
Colorectal cancer (CRC) represents a significant global health challenge. Although telomere maintenance plays a crucial role in tumorigenesis, the prognostic value and immunotherapeutic relevance of telomere maintenance genes (TMGs) in CRC remain poorly understood. In this study, relevant data were retrieved from The Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) databases. TMG scores were calculated using the single-sample gene set enrichment analysis (ssGSEA) method, and TMGs associated with prognosis were subsequently identified. TCGA-CRC samples were classified into subtypes via consensus clustering (ConsensusClusterPlus). A risk prediction model was then constructed using univariate and Lasso Cox regression analyses. Survival analysis was performed using Kaplan-Meier curves generated with the survival package. Key genes were validated in vitro using cellular models. Immune cell infiltration was evaluated through ssGSEA, TIMER, and MCP-Counter tools, and chemotherapy responses were predicted using the pRRophetic package. From 28 prognosis-related TMGs, two distinct CRC subtypes were established, with subtype C1 demonstrating more favorable clinical outcomes. Additionally, a risk model incorporating seven TMG-related genes (CDC25C, CXCL1, RTL8C, FABP4, ITLN1, MUC12, and ERI1) was developed for CRC prognosis. Differential mRNA expression levels of these genes were confirmed between CRC cell lines and normal control cells. Furthermore, silencing MUC12 suppressed CRC cell migration and invasion in vitro. Importantly, CRC patients classified as low-risk exhibited superior responses to immunotherapy, whereas high-risk patients showed increased sensitivity to conventional anti-cancer treatments. This study represents the first systematic evaluation of TMGs in CRC prognosis and immunotherapy, providing novel insights that could inform personalized therapeutic strategies.
结直肠癌(CRC)是一项重大的全球健康挑战。尽管端粒维持在肿瘤发生中起着关键作用,但端粒维持基因(TMGs)在CRC中的预后价值和免疫治疗相关性仍知之甚少。在本研究中,相关数据从癌症基因组图谱(TCGA)和基因表达综合数据库(GEO)中检索。使用单样本基因集富集分析(ssGSEA)方法计算TMG评分,随后鉴定与预后相关的TMGs。通过一致性聚类(ConsensusClusterPlus)将TCGA-CRC样本分为不同亚型。然后使用单变量和Lasso Cox回归分析构建风险预测模型。使用生存软件包生成的Kaplan-Meier曲线进行生存分析。使用细胞模型在体外验证关键基因。通过ssGSEA、TIMER和MCP-Counter工具评估免疫细胞浸润,并使用pRRophetic软件包预测化疗反应。从28个与预后相关的TMGs中,建立了两种不同的CRC亚型,其中C1亚型显示出更有利的临床结果。此外,还开发了一种包含7个与TMG相关基因(CDC25C、CXCL1、RTL8C、FABP4、ITLN1、MUC12和ERI1)的风险模型用于CRC预后。在CRC细胞系和正常对照细胞之间证实了这些基因的mRNA表达水平存在差异。此外,沉默MUC12可抑制CRC细胞在体外的迁移和侵袭。重要的是,被归类为低风险的CRC患者对免疫治疗表现出更好的反应,而高风险患者对传统抗癌治疗的敏感性增加。本研究首次对TMGs在CRC预后和免疫治疗中的作用进行了系统评估,提供了可为个性化治疗策略提供参考的新见解。