Ferroptosis Patterns Correlate with Immune Microenvironment Characterization in Gastric Cancer

Int J Gen Med. 2021 Oct 12:14:6573-6586. doi: 10.2147/IJGM.S331291. eCollection 2021.

Abstract

Objective: We aimed to build a ferroptosis-based classifier to characterize the molecular features of gastric cancers (GC) and investigate the relationship between different ferroptosis patterns and GC tumor microenvironment (TME).

Methods: Based on the genomic and clinical information from TCGA portal and GEO database, non-negative matrix factorization (NMF) was used to identify ferroptosis subtypes in GC patients. In order to estimate the ferroptosis levels, we established ferroptosis subtype score (FSS) to quantify ferroptosis patterns and ferroptosis potential index (FPI) by principal component analysis (PCA). The correlations of different ferroptosis patterns with TME cell-infiltrating characteristics (including immune cell infiltration, immune checkpoints expression levels, tumor mutational burden (TMB) and immunotherapy response) were systematically analyzed.

Results: Two ferroptosis subtypes, C1 (with lower FSS) and C2 (with higher FSS), were determined. C2 displayed a significantly lower FPI than C1. Besides, C2 was associated with diffuse subtype while C1 with intestinal subtype. As for TME characteristics, C2 was in accordance with the immune-excluded phenotype as it showed more active immune and stromal activities but lower TMB, less probability of immunotherapy response and poorer prognosis. C1 was linked to immune-inflamed phenotype as it had lower stromal activities but increased neoantigen load, enhanced response to immunotherapy and relatively better prognosis.

Conclusion: The systematic assessment of ferroptosis patterns and ferroptosis levels presented in our study implied that ferroptosis serves as an important factor in the formation of TME, which may expand the understanding of TME and provide a novel perspective for the development of targeted immunotherapeutic strategies for GC patients.

Keywords: ferroptosis; gastric cancer; immune cell infiltration; immunotherapy; tumor microenvironment.

Grants and funding

This study was supported by following fundings: Basic research program of Guangzhou Science and technology program – basic and applied basic research program (Doctoral young scientific and technological personnel) (Grant No. 202102020535); The First Affiliated Hospital of Guangzhou University of Chinese Medicine “Innovative Strong Hospital” Clinical Research Project (Grant No. No.2019IIT19); Natural Science Foundation of China (Grant No. 81973819); Youth Program of Natural Science Foundation of China (Grant No. 81904139); Major Subject Research Projects of Guangzhou University of Traditional Chinese Medicine (Grant No. A1-2606-19-110-007); Liu Fengbin, Guangdong Famous Traditional Chinese Medicine Inheritance Studio (Grant No. Guangdong TCM office [2020] no. 1); “Innovation Foster Hospital” Program of First Affiliated Hospital of Guangzhou University of Chinese Medicine (Grant No. 2017TD05); Natural Science Foundation of Guangdong Province (Grant No. 2017A030310121, 2019A1515011145); Guangdong Medical Science and Technology Research Fund (Grant No. A2020186); Innovation Development Project of the First Affiliated Hospital, Guangzhou University of Chinese Medicine (Grant No. 2019QN01).