Utilizing bioinformatics analysis to investigate the potential role of the FSTL1 gene in the development of gliomas.

The glioma gene expression levels and clinical data were downloaded from the Chinese Glioma Genome Atlas Project (CGGA) database. Glioma patients were categorized into high expression group (FSTL1 expression level ≥ 29.1 reads) and low expression group (FSTL1 expression level<29.1 reads) based on FSTL1 expression level. Differential gene analysis was conducted between the high and low expression groups, and perform gene ontology (GO) and gene set enrichment analysis (GSEA). The least absolute shrinkage and selection operator (LASSO) algorithm was applied to construct a prognostic model. It was also verified in the Glioma Longitudinal Analysis (GLASS) dataset.

High expression of FSTL1 is associated with poor clinical features, such as non-codelof 1p19q, IDH wildtype, higher grade (WHO Ⅲ-Ⅳ), etc. The prognosis of patients in the low expression group was significantly better than that in the high expression group, and the difference was statistically significant (P<0.05). GO analysis showed that DEGs is mainly concentrated in extracellular matrix tissue, immune-related, vascular system development, etc. The main pathways identified by gene enrichment analysis (GSEA) were: ECM_RECEPTOR_INTERACTION, G2M_CHECKPOINT, L6_JAK_STAT3_SIGNALING, and TNFA_SIGNALING_VIA_NFKB, etc. Compared with the low expression group, the high expression group showed higher immune and matrix scores, but lower purity scores (all P<0.001). Genes used for constructing the risk score were: ALDOC, GLC1, LINC00634, TGIF1, TPM4, and TRAM2. The Kaplan-Meier survival curve showed a poor prognosis of the high-risk score. Construct a survival prediction nomogram, and the subject operating characteristics and the correction curve all showed that the model had a good predictive ability.

FSTL1 is related to the clinical and molecular characteristics of glioma, and its expression is related to the degree of tumor malignancy, being a potential therapeutic target and an independent prognostic factor in glioma patients.