Ferroptosis-Linked Six-Gene Panel Enables Machine Learning-Assisted Diagnosis and Therapeutic Guidance in Lung Adenocarcinoma

铁死亡相关六基因检测组合可实现机器学习辅助的肺腺癌诊断和治疗指导

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Abstract

Lung adenocarcinoma (LUAD) remains the most common subtype of non-small-cell lung cancer and a major cause of cancer mortality, with many patients lacking actionable mutations or durable responses to targeted or immune therapies. Here, we report an integrative analysis of TCGA LUAD transcriptomes (n = 598) seeded from a curated ferroptosis gene catalogue, yielding a compact six-gene signature (AQP4, CDCA3, HJURP, KIF20A, PLK1, UHRF1) with diagnostic, prognostic, and therapeutic relevance. The signature was consistently dysregulated in tumours versus normal lung and stratified patients into high- and low-risk groups with distinct survival outcomes (log-rank p < 0.0001), outperforming conventional staging when incorporated into multivariable models. Across ten machine learning algorithms, the panel achieved near-perfect tumour-normal classification (AUC 0.99-1.00), highlighting its translational potential for early detection. Functional analyses linked the signature to cell-cycle, angiogenic, and immune modulation, while exploratory drug-gene correlations identified PLK1 and other candidates as potential therapeutic targets. Together, these findings establish a biologically anchored six-gene panel that complements existing mutation-based classifiers and provides a framework for advancing diagnostic precision, prognostic refinement, and biomarker-guided therapeutic strategies in LUAD.

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