Charting the immune terrain: a novel risk model for thyroid cancer prognosis

To construct a prognostic risk model for thyroid cancer based on immune genes and analyze the correlation between immune genes and immune infiltration.

A retrospective study was conducted on 180 patients with thyroid cancer treated in our hospital during May 2022 to April 2025. Based on the prognosis, the subjects were graded as good prognosis group of 126 cases and poor prognosis group of 54 cases. The influencing factors were analyzed by a binary logistic regression model, receiver operating characteristic curve and goodness of fit test. Single sample gene set enrichment analysis was used to perform immune infiltration analysis on the expression matrix of peripheral blood mononuclear cells. The GSEA algorithm was used to calculate the abundance of tumor associated immune cell infiltration. Pearson correlation analysis was used to investigate the correlation. The TCGA-THCA database was used to analyze the differential expression of genes, as well as the correlation with clinical pathological features.

The expression levels of CDK1, B3GNT7, S100A9, and MMP9 genes were higher in the poor prognosis group than the good prognosis group (P < 0.05). A prognostic prediction model was constructed according to formula [1/1 + exp (4.125 + 1.250 × CDK1 + 1.880 × B3GNT7 + 0.920 × S100A9 + 1.050 × MMP9)]. The average C-index of the model was 0.919 (95% CI: 0.882-0.961). The AUC of the prognosis prediction model was 0.880. The poor prognosis group had much lower infiltration abundance of B lymphocytes, CD4⁺T lymphocytes, and CD8⁺T lymphocytes, and higher infiltration abundance of neutrophils and macrophages than the good prognosis group (P < 0.05). CDK1, B3GNT7, S100A9, and MMP9 were negatively correlated with the infiltration abundance of B lymphocytes, CD4⁺T lymphocytes, and CD8⁺T lymphocytes, and positively correlated with the infiltration abundance of neutrophils and macrophages (P < 0.05). Further analysis from the TCGA-THCA database showed that the high expression of S100A9 and MMP9 was correlated with advanced lymph node metastasis (pN stage), distant metastasis (pM stage) and overall TNM stage (P < 0.05).

CDK1, B3GNT7, S100A9, and MMP9 were independent risk factors for poor prognosis in thyroid cancer. The prognostic prediction model may provide objective evidence for early screening of high-risk cases in clinical practice.