Immune infiltration and a ferroptosis-related gene signature for predicting the prognosis of patients with cholangiocarcinoma.

Cholangiocarcinoma (CHOL) is a digestive tract tumor with high malignancy and poor prognosis and is extremely challenging to treat. At present, induced cell death holds great promise in tumor therapy. Ferroptosis is a recently proposed pattern of programmed cell death, and numerous studies have shown that it is intimately involved in tumors. However, the roles of differentially expressed ferroptosis-related genes (DEFRGs) in CHOL have not been investigated. Our study was based on The Cancer Genome Atlas (TCGA) database, and DEFRGs were obtained to construct a prognostic riskScore model of CHOL by univariate and multivariate Cox regression analyses. Subsequently, the model was evaluated by nomogram construction, survival analysis, receiver operating characteristic (ROC) analysis, and exploration of the immune microenvironment. The mRNA and protein expression levels of each gene in the model were validated by the Gene Expression Omnibus (GEO) database, quantitative real-time PCR (qRT-PCR) and immunohistochemistry (IHC) staining. Our study found that the construction of a nomogram confirmed the predictive value of the model for overall survival (OS), and it was confirmed to have high diagnostic value by ROC analysis. Our experimental results were almost consistent with our bioinformatics results. In conclusion, we found that the prognostic model showed extremely high diagnostic and prognostic value and could predict the possibility of immunotherapy, thus providing a new direction for individualized treatment of patients with CHOL.