Prognostic Significance and Immune Microenvironment Infiltration Patterns of Hypoxia and Endoplasmic Reticulum Stress-Related Genes in Gastric Cancer

Libin Li Yizhi Liang Wenji Xu ^*

• Department of Gastroenterology,The Second Affiliated Hospital of Fujian Medical University, Quanzhou,Fujian, China., Quanzhou, China

Gastric cancer(GC) is a prevalent malignant neoplasm within the digestive system, accounting for approximately 740,000 deaths globally each year, significantly impacting patients' quality of life and survival rates. The objective of this investigation was to elucidate the expression patterns of Hypoxia and Endoplasmic Reticulum Stress-related Differentially Expressed Genes (HERSRDEGs) in GC and their association with prognostic outcomes of the patients. Utilizing The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases, GC datasets were retrieved, and standard normalization was performed. The acquired data revealed 19 HERSRDEGs including ANGPT2, CXCL8, and AURKA exhibiting significant variation in expression between GC and controls. In the Cox regression analysis, a total of five genes-ANGPT2, CD36, EGR1, NOX4, TLR2-emerged as statistically significant, correlating strongly with overall survival. A LASSO 2 regression model featuring ANGPT2, CD36, and NOX4 yielded a risk score formula capable of predicting patient outcomes. Furthermore, multivariate Cox regression analysis highlighted RiskScore, age and stage as significant survival predictors. The analysis of immune infiltration revealed notable differences in the populations of immune cells, such as Natural Killer cells and T-helper cells, when comparing highrisk and low-risk groups. We employed RT-qPCR to validate the mRNA expression levels of five model genes that impact the prognostic risk of gastric cancer in human gastric adenocarcinoma tissues. In conclusion, this investigation elucidates the involvement of HERSRDEGs in GC progression and their potential as prognostic biomarkers.