To the Editor, Colorectal cancer (CRC) is a malignance ranking the third cause of death in malignant tumors. 1 The high mortality of CRC is mainly caused by frequent postoperative metastasis and multidrug resistance. 2 A group of cancer stem cells (CSCs) have been discovered in CRC and the mRNA expression-based stemness index (mRNAsi) was considered as a novel indicator to measure cancer development and drug resistance. 3,4 In the present study, we first explored the prognosis of mRNAsi in CRC patients and identified the critical genes related to immune infiltration and drug resistance. The mRNAsi was much lower in normal samples than that in CRC tissues (P value = 7.458 × 10 −18) and indicated a favorable prognosis in patients with CRC (P = .016), which was inconsistent with our general understanding in other type of cancers (Figure 1A and B). 5-7 In addition, the mRNAsi had no relationship with clinical characteristics, including age, gender, tumor, node, metastasis (TNM) stage, and grade (Figure S1A). To explore the unique characteristic of mRNAsi in CRC, we performed the weighted gene co-expression network analysis of 6501 differentially expressed genes and identified 17 modules (Figure 1C and Figure S1B and C). Among them, the brown, green, and yellow modules showed significant relationship with mRNAsi with correlation index −0.71 (P = 4 × 10 −55), −0.71 (P = 8 × 10 −57), and 0.71 (P = 1 × 10 −55), respectively (Figure 1D). In total, 193 critical genes related to mRNAsi (135 genes in brown, 48 genes in green, and 10 genes in yellow) were filtrated (Figure 1E, Table S1). We found 24 key genes were significant closely associated with poor prognosis in CRC by univariate analysis (Figure 1F, Table S2). Causal relationship with proteins were analyzed by DisNor and indicated that these genes were closely connected and associated with adipogenesis (Figure 1G). This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.