BIRC5 as a Potential Biomarker and Therapeutic Target for Lung Adenocarcinoma: A Comprehensive Bioinformatics Analysis

Lung adenocarcinoma (LUAD), the most prevalent type of non-small cell lung cancer (NSCLC), has the highest incidence and mortality rates among thoracic cancers worldwide. BIRC5, a protein linked to tumor cell proliferation, differentiation, migration, and invasion, has been insufficiently studied as a potential LUAD biomarker. In this study, we used bioinformatics techniques to analyze LUAD-related data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases to identify biomarkers associated with LUAD onset, progression, and prognosis and evaluate their clinical significance. Immune cell infiltration and single-cell RNA sequencing analyses assessed the expression of core genes in various immune environments. Drug sensitivity analysis evaluated the impact of these biomarkers on treatment response, providing a basis for early diagnosis and personalized LUAD treatment. Gene expression and clinical data from TCGA and GEO underwent weighted correlation network analysis (WGCNA), differential analysis, and univariate and multivariate Cox regression to identify prognostic core genes. High BIRC5 expression emerged as an independent risk factor for poor overall survival (OS) in LUAD, exhibiting strong diagnostic performance. Enrichment analysis indicated that BIRC5 was involved in the cell cycle and P53 signaling pathways. Single-cell RNA sequencing and immune infiltration analyses revealed that BIRC5 plays a critical role in the immune microenvironment. Drug sensitivity analysis showed that high BIRC5 expression correlated with increased sensitivity to several anticancer drugs. These findings establish BIRC5 as a promising biomarker for LUAD diagnosis and prognosis. Its role in immune regulation and drug sensitivity highlights its potential for guiding personalized treatment strategies.