Unraveling the role of coagulation-related genes in esophageal squamous cell carcinoma: development of a prognostic model and exploration of potential clinical significance.

Background: Esophageal squamous cell carcinoma (ESCC), the most common form of esophageal cancer, is associated with high incidence and mortality rates, representing a major public health challenge. Although previous research has suggested a link between coagulation dysfunction and cancer progression, the precise role of coagulation-related genes in ESCC remains poorly understood. Methods: To investigate this, we integrated various multi-omics datasets, including mRNA expression data from TCGA and GEO, single-cell RNA sequencing data, as well as DNA mutation and methylation profiles. By applying machine learning algorithms, we identified coagulation-related genes in ESCC and developed a predictive model with clinical relevance. Further analyses were performed to assess the biological functions, prognostic significance, clinical implications, immune interactions, and drug sensitivity associated with these genes. Results: In this study, we identified seven coagulation feature genes-RAP1B, SRC, CFHR4, PLA2G4A, ORAI1, RINT1, and SPTB-in ESCC. A prognostic model based on these genes effectively stratified patients and demonstrated robust predictive value for clinical outcomes. Further analysis revealed distinct differences in immune function, drug sensitivity, and disease-related pathways between high- and low-risk groups. Among these genes, RINT1 emerged as a key factor, with pan-cancer analysis highlighting its potential relevance across multiple tumor types. We used immunohistochemistry, qRT-PCR, and Western blot to validate its differential expression in ESCC, highlighting its potential as a therapeutic target. Conclusion: Our findings emphasize the significance of coagulation-related genes in ESCC progression and their involvement in critical biological and immune processes. The proposed prognostic model provides a valuable tool for risk assessment. Additionally, the identification of RINT1 provides new insights as a potential prognostic biomarker and candidate for future therapeutic investigation in ESCC patients.