Page 249 - EJMO-9-2

Eurasian Journal of
Medicine and Oncology Prognosis of colon adenocarcinoma

A B

C D

Figure 5. Distribution of immune cells in high- and low-risk groups. (A) Immune cell infiltration in the high- and low-risk groups of the total TCGA
cohort. (B) Differences in immune function between high- and low-risk groups in the total TCGA cohort. (C) Immune cell infiltration between high- and
low-risk groups in the GEO external validation cohort. (D) Differences in immune function between high- and low-risk groups in the GEO external
validation cohort.
Abbreviations: APC: Antigen-presenting cell; CCR: Chemokine receptor; HLA: Human leukocyte antigen; MHC: Major histocompatibility class;
TCGA: The cancer genome atlas; GEO: Gene Expression Omnibus.

with various immunological disorders and can be used to 3.9. Association between mRNA risk score
categorize individuals as high or low risk. and clinical characteristics and the role of risk
stratification in response to chemotherapy
3.7. GSEA
We analyzed risk differences for several pathological
The five most significant pathways enriched in the low-risk clinical characteristics, drawing on clinical data from the
group are displayed in Figure 6. These pathways include TCGA and GEO databases. The TCGA cohort showed
calcium signaling, dilated cardiomyopathy, hypertrophic that T stage (Figure 8C), N stage (Figure 8D), M stage
cardiomyopathy, neuroactive ligand-receptor interaction, (Figure 8E), and clinical stage (Figure 8F) significantly
and vascular smooth muscle contraction pathways. differed (p<0.05) between high- and low-risk groups, but
age (Figure 8A) and sex (Figure 8B) differences were not
3.8. Independent prognostic value of the risk significant (p>0.05). Results were similar in the TCGA
signature
and GEO queues (Figure 8G-L). We further investigated
In addition to clinical factors, univariate and multivariate whether the mRNA risk signature could predict responses
Cox regression analyses were conducted on the TCGA to commonly used chemotherapeutic agents in colorectal
and GEO cohorts, respectively. Following multivariate cancer patients. Notably, a significantly higher proportion
correction for the variables above, the mRNA risk signature of high-risk patients exhibited resistance to xeloda,
was found to be a robust and independent prognosis camptothecin-11, and L-OHP (Figure A2B-D), with the
predictor for patients with colorectal cancer (hazard exception of 5-fluorouracil (p<0.05; Figure A2A).
ratio=1.012, 95% confidence interval=1.008 – 1.017,
p<0001; Figure 7A and B). Similar outcomes were observed 3.10. Nomogram construction and assessment of
in the GEO external validation group (Figure 7C and D; predictive value
hazard ratio=1.028, 95% confidence interval=1.011 – To anticipate the prognosis of patients with colorectal
1.063, p<0.05). cancer at 1, 3, and 5 years out, we constructed a Cox-factorial

Volume 9 Issue 2 (2025) 241 doi: 10.36922/EJMO025060024