Prognostic and Immune Infiltration Analysis in ESCC Using a Ferroptosis-EMT Biomarker Signature

Limited studies have explored how ferroptosis and Epithelial- Mesenchymal Transition (EMT) jointly affect the prognosis of Esophageal Squamous Cell Carcinoma (ESCC). This study aimed to develop a clinical prognostic model based on the combined impact of ESCC.

Gene expression levels and clinical data of ESCC patients were obtained from the Gene Expression Omnibus (GEO) and the Cancer Genome Atlas (TCGA) database. Using Cox regression analysis and Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis, we identified nine prognostic genes to build a predictive model. Immune cell infiltration was evaluated using CIBERSORT and single-sample Gene Set Enrichment Analysis methods. Finally, in vitro experiments were conducted to assess the oncogenic effects of ACSL3 and VIM.

We developed a Ferroptosis-EMT Integrated Score (FEIS) based on nine key genes. High-FEIS patients had worse survival, increased immune infiltration, and higher expression of immune checkpoints. A nomogram was built for prognosis prediction, and in vitro studies confirmed the tumor-promoting roles of ACSL3 and VIM.

The FEIS model robustly predicts ESCC prognosis by integrating ferroptosis and EMT, offering novel biomarkers for personalized immunotherapy, though further validation is warranted.

Our study introduced a novel prognostic tool that integrates ferroptosis and EMT-related biomarkers and offers valuable insights for developing personalized treatment strategies for ESCC patients.