Diagnostic and prognostic values of forkhead box D4 gene in colonic adenocarcinoma

Previous studies found that Forkhead box D4 (FOXD4) overexpressed in human colorectal cancer had the worst prognosis. However, the diagnostic value and further mechanism have not been fully researched. Statistical examinations for FOXD4 expression colon adenocarcinoma (COAD) patients were obtained from The Cancer Genome Atlas (TCGA). Survival analysis was used to assess its prognostic value. Nomogram model was used for visual prediction of patient survival rate. The online functional enrichment analysis tool was used to evaluate the biological functions and pathways of FOXD4 and its co-expressed genes. Receiver operating characteristic curve analysis suggested that FOXD4 might be a diagnostic biomarker for COAD (P<0.001, area under the curve [AUC]=0.728, 95% confidence interval [CI]=0.669-0.787). Low expression of FOXD4 was associated with a good clinical outcome (P=0.001, HR=0.517, 95% CI=0.341-0.782). A total of 797 genes were correlated with FOXD4 and associated with cell proliferation, cell differentiation, nuclear matrix, Rap1 signaling pathway, RNA transport, and VEGF signaling pathway. In conclusion, expression of FOXD4 may be a diagnostic and prognostic biomarker in COAD.