Identification of radiotherapy-sensitive genes for predicting prognosis, immune microenvironment, and drug sensitivity in uterine carcinosarcoma patients.

backgroundUterine carcinosarcoma is a rare gynecological malignancy characterized by high invasiveness and poor prognosis. At present, common treatment methods include surgery, chemotherapy, and radiotherapy. Radiotherapy can induce tumor cells to produce reactive oxygen species through ionizing radiation, leading to damage to intracellular DNA and mediating tumor cell death. Based on this, we identified a novel radiotherapy sensitive gene for predicting the prognosis, immune microenvironment, and drug sensitivity of uterine carcinosarcoma patients.

methodsThe Cancer Genome Atlas database was used to obtain genetic and clinical information of patients with uterine carcinosarcoma. A risk scoring model was built using Lasso regression model. In order to enhance the predictive ability of the model, a column chart for prediction was created and calibration curves were used. Gene set enrichment analysis was used to evaluate pathway enrichment in patients with different risk cohorts. Finally, we investigated drug sensitivity between high-risk and low-risk cohorts.

resultsWe found that the survival rate of patients who received radiotherapy was significantly higher than that of patients who did not receive radiotherapy. In the constructed risk scoring model, high-risk patients have a worse prognosis. Pathway enrichment indicates that high-risk patients are enriched in regulating tumor cell growth, metabolism, and angiogenesis pathways, which may be a reason for poor prognosis in high-risk patients. High risk and low-risk patients have different sensitivities to different drugs. The 1, 3, and 5-year survival values predicted by the receiver operating characteristic curve were 0.82, 0.93, and 0.96, respectively, indicating the reliability of our prediction model. Finally, multiple regression analysis showed that the radiation therapy sensitive genes SSBP2, ELAVL3, and CST1 in the model can independently affect the prognosis of patients with uterine carcinosarcoma. Patients with high expression of SSBP2 have a better prognosis than those with low expression, while patients with high expression of ELAVL3 and CST1 have a poorer prognosis.

conclusionWe have developed a scoring method for uterine carcinosarcoma based on the effectiveness of radiotherapy. This method can evaluate the prognosis of patients with uterine carcinosarcoma and has certain guiding significance for the clinical treatment of subsequent uterine carcinosarcoma patients.