Establishment and validation of an immune-related nomogram for the prognosis of pancreatic adenocarcinoma

Abstract Pancreatic adenocarcinoma (PDAC) is a highly aggressive neoplasm characterized by limited therapeutic options, particularly in the realm of immunotherapy. This study aims to improve prognosis prediction to guide therapeutic decision-making, and to identify novel targets for immunotherapy of...

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Main Authors: Kan Wang, Yunkun Lu, Yanfei Cao, Ping Feng, Qiu Wu, Peng Xiao, Yimin Ding
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-98503-0
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author Kan Wang
Yunkun Lu
Yanfei Cao
Ping Feng
Qiu Wu
Peng Xiao
Yimin Ding
author_facet Kan Wang
Yunkun Lu
Yanfei Cao
Ping Feng
Qiu Wu
Peng Xiao
Yimin Ding
author_sort Kan Wang
collection DOAJ
description Abstract Pancreatic adenocarcinoma (PDAC) is a highly aggressive neoplasm characterized by limited therapeutic options, particularly in the realm of immunotherapy. This study aims to improve prognosis prediction to guide therapeutic decision-making, and to identify novel targets for immunotherapy of PDAC. We conducted Cox and LASSO regression analyses to develop immune-related gene signature and corresponding nomogram, and the robustness of these signatures was demonstrated using multiple approaches. Additionally, CIBERSORT, ESTIMATE, and xCell algorithms were utilized to assess immune cell infiltration, with experimental validation performed though qPCR. An immune-related gene signature consisting of 18 genes, and the prognostic nomogram was established with superior performance compared to the conventional staging system. Key parameters incorporated into the nomogram included the gene signature, tumor stage, and postoperative treatment. Patients identified as high-risk exhibited an anti-inflammatory tumor microenvironment, characterized by an increase in M2-like tumor-associated macrophages and heightened tumor purity. Notably, the expression of interleukin 6 receptor (IL6R) in PDAC was predominantly derived from macrophages and was significantly associated with patient survival outcomes. Furthermore, attenuated IL-6/IL-6R signaling was found to promote M2-like macrophage differentiation. This study successfully established an immune-related gene signature and a robust nomogram for predicting clinical outcomes in patients with PDAC. Furthermore, we identified IL6R as a promising target for future immunotherapeutic strategies.
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spelling doaj-art-fd82b40452d6434c81dccf292d553e792025-08-20T03:18:53ZengNature PortfolioScientific Reports2045-23222025-04-0115111310.1038/s41598-025-98503-0Establishment and validation of an immune-related nomogram for the prognosis of pancreatic adenocarcinomaKan Wang0Yunkun Lu1Yanfei Cao2Ping Feng3Qiu Wu4Peng Xiao5Yimin Ding6Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of MedicineDepartment of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of MedicineDepartment of Gastroenterology, The Third Affiliated Hospital of Zhejiang University of Traditional Chinese MedicineDepartment of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of MedicineDepartment of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of MedicineDepartment of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of MedicineDepartment of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of MedicineAbstract Pancreatic adenocarcinoma (PDAC) is a highly aggressive neoplasm characterized by limited therapeutic options, particularly in the realm of immunotherapy. This study aims to improve prognosis prediction to guide therapeutic decision-making, and to identify novel targets for immunotherapy of PDAC. We conducted Cox and LASSO regression analyses to develop immune-related gene signature and corresponding nomogram, and the robustness of these signatures was demonstrated using multiple approaches. Additionally, CIBERSORT, ESTIMATE, and xCell algorithms were utilized to assess immune cell infiltration, with experimental validation performed though qPCR. An immune-related gene signature consisting of 18 genes, and the prognostic nomogram was established with superior performance compared to the conventional staging system. Key parameters incorporated into the nomogram included the gene signature, tumor stage, and postoperative treatment. Patients identified as high-risk exhibited an anti-inflammatory tumor microenvironment, characterized by an increase in M2-like tumor-associated macrophages and heightened tumor purity. Notably, the expression of interleukin 6 receptor (IL6R) in PDAC was predominantly derived from macrophages and was significantly associated with patient survival outcomes. Furthermore, attenuated IL-6/IL-6R signaling was found to promote M2-like macrophage differentiation. This study successfully established an immune-related gene signature and a robust nomogram for predicting clinical outcomes in patients with PDAC. Furthermore, we identified IL6R as a promising target for future immunotherapeutic strategies.https://doi.org/10.1038/s41598-025-98503-0Pancreatic adenocarcinomaImmune-related gene signaturePrognosis nomogramIL6RMacrophages
spellingShingle Kan Wang
Yunkun Lu
Yanfei Cao
Ping Feng
Qiu Wu
Peng Xiao
Yimin Ding
Establishment and validation of an immune-related nomogram for the prognosis of pancreatic adenocarcinoma
Scientific Reports
Pancreatic adenocarcinoma
Immune-related gene signature
Prognosis nomogram
IL6R
Macrophages
title Establishment and validation of an immune-related nomogram for the prognosis of pancreatic adenocarcinoma
title_full Establishment and validation of an immune-related nomogram for the prognosis of pancreatic adenocarcinoma
title_fullStr Establishment and validation of an immune-related nomogram for the prognosis of pancreatic adenocarcinoma
title_full_unstemmed Establishment and validation of an immune-related nomogram for the prognosis of pancreatic adenocarcinoma
title_short Establishment and validation of an immune-related nomogram for the prognosis of pancreatic adenocarcinoma
title_sort establishment and validation of an immune related nomogram for the prognosis of pancreatic adenocarcinoma
topic Pancreatic adenocarcinoma
Immune-related gene signature
Prognosis nomogram
IL6R
Macrophages
url https://doi.org/10.1038/s41598-025-98503-0
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