Polyamine metabolism plays an essential role in glioma progression and the tumor microenvironment (TME). However, its prognostic and immunotherapeutic significance remains incompletely understood. We integrated transcriptomic and clinical data from The Cancer Genome Atlas (TCGA) to construct a prognostic risk model via Least Absolute Shrinkage and Selection Operator (LASSO) regression. This model was externally validated using the GSE108474 and GSE43378 cohorts. Multivariable Cox regression was employed to identify key prognostic predictors, while consensus clustering was applied to stratify patients into distinct molecular subtypes. A robust 19-gene signature was established to calculate risk scores, effectively categorizing patients into high- and lowrisk groups with significantly divergent survival outcomes. From this signature, five genes were identified as independent prognostic factors via multivariable Cox analysis. Ultimately, three prioritized core candidate biomarkers (AGMAT, PSMC5, and SMS) were extracted, among which SMS exhibited exceptionally high individual diagnostic efficacy. Furthermore, consensus clustering delineated two distinct subgroups (C1 and C2). The C1 subtype exhibited a less immune-infiltrated phenotype but higher PD-L1 expression and elevated TIDE scores, indicating stronger immune evasion and poorer survival. In contrast, the C2 subtype was characterized by robust immune cell infiltration, a more favorable prognosis, and a superior computationally predicted response to immunotherapy. In conclusion, our polyamine metabolism-related gene signature may serve as a promising candidate biomarker for evaluating clinical outcomes and computationally estimated immunotherapy efficacy in glioma. While this risk model and molecular subtyping framework offer novel insights for therapeutic stratification, prospective clinical validation is required.
[1]Tianjin Med Univ, Coll Basic Med Sci, Dept Biomed Sci, Tianjin 300070, Peoples R China.
[2]Soochow Univ, Affiliated Hosp 2, Dept Neurosurg, Suzhou 215004, Peoples R China.
[3]Taihe Hosp, Wannan Med Coll, Dept Neurosurg, Fuyang 236600, Peoples R China.
[4]Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Natl Clin Res Ctr Canc, Canc Hosp,Dept Neurosurg, Beijing 100021, Peoples R China.
(8.0+极速模式)