Integrative analyses of bulk, single-cell and spatial transcriptomics identified diabetes mellitus-related signature as a prognostic factor in pancreatic adenocarcinoma

Abstract

Purpose Pancreatic adenocarcinoma (PAAD) is a deadly disease, particularly for those with diabetes mellitus (DM). While there have been various studies on prognostic factors in pancreatic cancer, few have specifically focused on PAAD patients with DM. This study aimed to identify differentially expressed genes (DEGs) between DM and non-DM individuals and develop a predictive model. Materials and Methods PAAD patients with DM were divided into training (70%) and test (30%) groups, and OS-associated genes were identified using univariate COX analysis. A 10-gene risk model was constructed using LASSO-penalized COX regression with ten-fold cross-validation. Results The model showed a C-index of 0.83 in the training group and 0.76 in the test group. High risk group represented a tumor-growth and angiogenic phenotype and the low group represented an immune-active phenotype. Conclusion This prognostic model holds promise for predicting overall survival in PAAD patients with DM, indicating potential benefits from immunotherapy for those with low-risk scores.