A dual EMT-ferroptosis gene signature predicts survival and immune infiltration in esophageal squamous cell carcinoma

Background : Limited research has been conducted on the interaction between ferroptosis and epithelial-mesenchymal transition (EMT) and their combined effect on esophageal squamous cell carcinoma (ESCC) patient prognosis. The present study aimed to develop a prognostic model based on the impact of ferroptosis and EMT on ESCC prognosis for clinical application. Methods : Gene expression levels and clinical data of ESCC patients were obtained from the GSE53625 dataset in the gene expression omnibus (GEO) database, and the data from the cancer genome atlas (TCGA) were obtained as a validation set. By combining the results of cox regression analysis and least absolute shrinkage and selection operator regression (LASSO) analysis, we selected nine genes associated with prognosis, which were then used to construct a prognostic model. Immune cell infiltration was evaluated using CIBERSORT and single-sample Gene Set Enrichment Analysis methods. Results : Nine key genes were screened to construct ferroptosis and EMT integrated score (FEIS). Compared to the low-FEIS group, the high-FEIS group demonstrated shorter overall survival period. The immune infiltration analysis showed an increase in immune cell infiltration and elevated expression levels of immune checkpoint molecules in the high-FEIS group. A nomogram was constructed to accurately predict patient prognosis. Conclusion : Our study introduced a novel prognostic tool that integrates ferroptosis -and EMT-related biomarker, and offered valuable insights for developing personalized treatment strategies for ESCC patients.