Abstract
Colon adenocarcinoma (COAD) is a leading cause of cancer-related mortality worldwide, with immune escape being a significant factor in the failure of immunotherapy. This study investigates the correlation between Immunosurveillance-related genes and the prognosis of COAD patients, utilizing data from 1140 patients across four public databases: The Cancer Genome Atlas (TCGA), International Cancer Genome Consortium (ICGC), Array-express, and Gene Expression Omnibus (GEO). Employing Cox regression analysis, we identified 182 immune genes significantly linked to overall survival (OS) and established an Immunosurveillance score (ISs) based on 16 of these genes. The ISs score was validated using independent datasets, revealing that patients in the high-ISs group exhibited significantly poorer OS compared to those in the low-ISs group, as demonstrated by Kaplan-Meier curves and Cox regression analyses. Moreover, the ISs score showed a negative correlation with immune scores across multiple datasets. Notably, a higher ISs score was associated with improved recurrence-free survival (RFS) and OS in patients treated with PD-1 and CTLA4 inhibitors. Our findings suggest that the ISs score, derived from Immunosurveillance-related genes, has the potential to serve as a valuable prognostic marker and a tool for identifying COAD patients who may benefit from immunotherapy in clinical settings.