A signature of ferroptosis-related genes in the prognosis and tumor microenvironment of Cervical squamous cell carcinoma and endocervical adenocarcinoma

Abstract Background: The role of iron death in cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) is unclear. This study is based on the TCGA data set to explore the expression of ferroptosis-related genes (FRGs) in CESC and its clinical value. Methods: We download the transcriptome and clinical data of CESC patients from the Cancer Genome Atlas of America (TCGA). R 4.4.0 software was used to analyze the differential expression of FRGs (DEFGs) and survival data to construct a risk prognostic model, determine the signature related to ferroptosis, and calculate the tumor microenvironment score of CESC. Then we analyzed the correlation between the ferroptosis-related signature, patient prognosis and tumor microenvironment score. GEPIA database and HPA database verified the differences in the expression and survival of DFRGs in normal cervical tissues and CESC tissues. Results: Compared with normal cervical tissues, there were 14 DEFGs in CESC, 12 were up-regulated and 2 were down-regulated. Finally, four prognostic-related DEFGs (ACACA, PHKG2, SQLE and TFRC) were obtained to construct a prognostic risk model. It was found that the survival time was longer in the low-risk group (HR=0.444, 95%CI: 0.279-0.707), and the stromal score, immune score and estimated score were higher (P<0.05). The verification in the GEPIA database and HPA database is basically consistent with our results. Conclusion: The ferroptosis-related signature is significantly correlated with the survival and prognosis of CESC patients and the tumor microenvironment, suggesting that 4 DEFGs may be potential therapeutic targets and prognostic markers of CESC.