Subtyping colorectal cancer based on septic shock-associated genes: prognosis and immune characteristics

Sepsis and colorectal cancer (CRC) are leading causes of death. Given their mutual dependence for susceptibility, we used bioinformatics to explore potential connections between septic shock (SS) and CRC.

We identified 452 co-expressed genes between SS-related differential expression genes (SS-DEGs) and CRC patient-expressed genes (TCGA-CRC genes). CRC samples were categorized into two cluster subgroups through hierarchical clustering. We then compared the prognosis and immune landscapes of the two cluster subgroups through survival analysis, immune microenvironment analysis, and immune therapy response evaluation.

Clustering analysis of the 452 CRC patient-expressed SS-DEGs identified two subtypes: SS-like CRC (SL-CRC) and non-SS-like CRC (NSL-CRC). There were no significant differences in overall survival between the CRC subtypes. However, the subtypes displayed significant differences in immune score, stromal score, and ESTIMATE score. Based on immune therapy databases, there were also significant differences in responses to anti-CTLA-4 and anti-PD-1 immune checkpoint inhibitors between the subtypes.

Our study reveals significant differences in the immune microenvironment and immune therapy responses between SL-CRC and NSL-CRC subtypes. These findings provide a foundation for identifying new therapeutic targets and developing personalized treatment strategies for specific CRC subtypes.