High expression of TTC21A predict poor prognosis of colorectal cancer and influence the immune infiltrating level

Transl Cancer Res. 2022 May;11(5):981-992. doi: 10.21037/tcr-21-2674.

Abstract

Background: Colorectal cancer (CRC) is the third most common malignancy. Immunoinvasion of tumor microenvironment was positively correlated with overall cancer survival. TTC21A is a little-reported gene in tumors, and its mechanism of action remains unclear. Our study used The Cancer Genome Atlas (TCGA) data to evaluate the role of TTC21A in CRC.

Methods: Software R3.6.3 analyzed the expression of TTC21A in CRC. We assessed the impact of TTC21A on the survival of CRC patients through a survival module. The CRC data set was then downloaded from TCGA. Logistic regression was used to analyze the correlation between clinical information and TTC21A expression. Cox regression analysis showed that clinicopathological characteristics of TCGA patients were correlated with overall survival. In addition, we used ssGSEA to explore the correlation between TTC21A and tumor immune invasion.

Results: High expression of TTC21A is significantly correlated with advanced pathological stage and poor overall survival. In multivariate analysis, the up-regulated TTC21A expression, high tumor stage, and distant metastasis are independent prognostic factors of poor prognosis. Moreover, a negative correlation between increased TTC21A expression and immune infiltrating T cells and neutrophils cells was established.

Conclusions: High expression of TTC21A was associated with poor prognosis of CRC and affected the proportion of immune cells such as T cells, neutrophils, and NK cells. These results suggest that TTC21A can be used as a potential biomarker to evaluate the prognosis and level of immune invasion in CRC.

Keywords: Colorectal cancer (CRC); TTC21A; gene expression data; tetratricopeptide; tumor-infiltrating lymphocytes (TILs).