Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Apr 15, 2025; 17(4): 103113
Published online Apr 15, 2025. doi: 10.4251/wjgo.v17.i4.103113
Using bioinformatics methods to elucidate fatty acid-binding protein 4 as a potential biomarker for colon adenocarcinoma
Yun Zhang, Wen-Li Zhu, Min Wu, Tian-Yuan Gao, Hui-Xian Hu, Zheng-Yuan Xu
Yun Zhang, Hui-Xian Hu, Zheng-Yuan Xu, Department of Medical Engineering, Wannan Medical College, Wuhu 241002, Anhui Province, China
Wen-Li Zhu, Seven Inpatient Ward, The Fourth People's Hospital of Wuhu, Wuhu 241002, Anhui Province, China
Min Wu, Sixteen Inpatient Ward, The Fourth People's Hospital of Wuhu, Wuhu 241002, Anhui Province, China
Tian-Yuan Gao, Department of Pathology, The Second Affiliated Hospital of Wannan Medical College, Wuhu 241000, Anhui Province, China
Co-first authors: Yun Zhang and Wen-Li Zhu.
Co-corresponding authors: Hui-Xian Hu and Zheng-Yuan Xu.
Author contributions: Xu ZY and Hu HX designed the research study; Zhang Y and Zhu WL collected the data; Zhang Y and Zhu WL wrote the paper; Wu M and Gao TY performed the statistical analyses; Wu M and Gao TY revised the manuscript; and all the authors checked and approved the final manuscript. Zhang Y and Zhu WL contributed equally to this work as co-first authors. Xu ZY and Hu HX were appointed as corresponding authors for this paper. First, the two associate professors participated in the design of the research study, provided research ideas, made important revisions to the paper during the writing process, and ultimately finalized the manuscript. Second, these two associate professors played a significant role in project management and team collaboration. Finally, Associate Professor Xu ZY also obtained funding, and Associate Professor Hu HX participated in the submission and communicated with the journal. Therefore, both corresponding authors have made important contributions to the article, and these contributions are equal. For this reason, the article designates these two authors as co-corresponding authors.
Supported by the University Scientific Research Project of Anhui Province, No. 2024AH051916; the Quality Engineering Project of Anhui Province, No. 2022sx159 and No. 2022sdxx031; and the Key Research and Development Project of Anhui Province, No. 2022e07020036.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Wannan Medical College, No. (2023) 215.
Informed consent statement: Signed informed consent was obtained from all participants in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data will be made available on reasonable request at xuzy@wnmc.edu.cn.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zheng-Yuan Xu, Department of Medical Engineering, Wannan Medical College, No. 22 Wenchang Road, Wuhu 241002, Anhui Province, China. xuzy@wnmc.edu.cn
Received: November 13, 2024
Revised: January 7, 2025
Accepted: February 14, 2025
Published online: April 15, 2025
Processing time: 133 Days and 15.1 Hours
Abstract
BACKGROUND

Colon adenocarcinoma (COAD) ranks second in terms of cancer-related deaths. We found that fatty acid-binding protein 4 (FABP4), which is related to cell adhesion and immunity, affects the occurrence and development of COAD. This study focused on the possibility of using FABP4 as a biomarker for COAD and constructed a nomogram for predicting the survival of COAD patients.

AIM

To verify the possibility of using FABP4 as a biomarker for COAD.

METHODS

A total of 453 COAD tissue samples, along with 41 normal tissue samples, were obtained from The Cancer Genome Atlas database. The difference in FABP4 expression between COAD tissues and normal tissues was analyzed, and the results were verified by immunohistochemistry. The WGCNA algorithm links FABP4 expression with an enrichment analysis and with immune cell infiltration pathways. The biological functions of FABP4 and its coexpressed genes were explored through enrichment analyses. The ESTIMATE, CIBERSORT and ssGSEA methods were used for the immune infiltration analysis. Finally, risk scores were calculated by a Cox analysis. A nomogram was constructed by combining risk scores with routine clinicopathological factors. We assessed the accuracy of survival predictions based on the C-index. The C-index ranges from 0.5 to 1.0, and in general, a C-index value greater than 0.65 indicates a reasonable estimate. The results were validated using the Gene Expression Omnibus (GEO) database.

RESULTS

FABP4 was significantly differentially expressed in COAD. It is a promising auxiliary biomarker for screening and diagnosis. Enrichment analyses suggested that FABP4 may influence the invasion and progression of COAD through cell adhesion. The immunological analysis revealed that FABP4 expression in COAD was significantly positively correlated with immune cell infiltration. Moreover, a nomogram to predict the survival of COAD patients was successfully constructed by integrating the calculated risk scores of 15 candidate genes and routine clinicopathological factors. This nomogram could effectively predict 1-year, 3-year, and 5-year survival (C-index = 0.786) and was verified (C-index = 0.73).

CONCLUSION

This study established FABP4 as an effective biomarker for screening, assisting in the diagnosis and determining the prognosis.

Keywords: FABP4; Colon adenocarcinoma; Biomarker; Cell adhesion; Immune pathways; Prognostic nomogram

Core Tip: Fatty acid-binding protein 4 (FABP4) can be used as a biomarker of colon adenocarcinoma (COAD). Based on this, a nomogram was constructed to effectively predict the survival of COAD patients. FABP4 influences COAD invasion and progression through cell adhesion and immune-related pathways.