Identification of m6A- and ferroptosis-related lncRNA signature for predicting immune efficacy in thymoma

BACKGROUND: N6-methyladenosine (m6A) methylation and ferroptosis assist long non-coding RNAs (lncRNAs) to promote immune escape in thymoma (THYM). However, the predictive power of m6A and ferroptosis-associated lncRNAs in immune potency remains unknown. METHODS: A total of 120 THYM samples with complete data were obtained from The Cancer Genome Atlas (TCGA) database as the training cohort, and half of them were randomly composed as the validation cohort, and various methods such as regression analysis and enrichment analysis were applied to screen, evaluate, etc. RESULTS: We constructed prognosis-associated mfrlncRNA pairs after screening for lncRNAs associated with m6A regulators and ferroptosis-associated genes. According to this, the mfrlncRNA signature was founded utilizing least absolute shrinkage and selection operator (LASSO) analysis and Cox regression. We found that patients' risk score was an independent risk factor and was much better than clinical stage as an indicator. In addition, patients in the high-risk group had a poorer prognosis with higher B cells naive and Macrophages M0/M1/M2 infiltration, lower Plasma cells and T cells CD4 naive infiltration, higher immune escape potential (higher TIDE score) and higher IC50. Finally, mfrlncRNA signature contributes to risk prediction in THYM patients and prognostic improvement. CONCLUSIONS: The mfrlncRNA signature has great prognostic value and may help to explore the relevant immune mechanisms in depth, with key implications for individualized treatment to improve the prognosis of THYM patients.