Comprehensive Analysis Between Ferroptosis-Related Gene Signatures and Neuroblastoma Prognosis

Background: Neuroblastoma (NB) is one of the most common extracranial malignancies in central nervous system, threatening children’s health. It is an embryonic neural crest cell-derived pediatric solid tumor, usually resulting in tumors in the adrenal glands or the sympathetic ganglia. The clinical presentation can be quite heterogeneous, ranging from asymptomatic incidental tumors to widespread metastases with systemic manifestations. While children diagnosed with clinically stable NB can be completely cured, those with high-risk NB have a poor prognosis despite combination therapy strategies. In order to assess the prognosis of NB patients, sensitive biomarkers are worthy of in-depth study. Methods: We obtain raw data from TARGET and GEO databases. Next, the role of ferroptosis death-related genes (FRGs) as a prognostic biomarker for NB patients was discussed. And Pearson correlation analysis and Cox regression analysis were used to select FRGs related to prognosis. Results: Five genes were selected to construct a prognostic prediction model in the TARGET cohort. The risk score was calculated based on 5 FRGs. And according to the median value of risk score, patients were divided into low-risk group and high-risk group. The high-risk group has relatively higher abundance among immune cells. The expression of immuno-oncology target is up-regulated in patients with high-risk scores. In addition, the high-risk group is more related to oxidative phosphorylation and MTORC1 signaling. And to assess the overall survival (OS) of NB patients, a nomogram (based on MKI, COG risk group and risk score) was also established. Conclusion: FRGs can be used as sensitive biomarkers to predict the prognosis of NB patients, and can be used in clinical immunotherapy and targeted therapy.