Lactylation-related genes signature panel in hepatocellular carcinoma reveals the prognostic and therapeutic optimization

Lactylation-related genes (LRGs) exert a significant influence on tumor progression and are critically involved in modulating responses to immune checkpoint inhibitors (ICIs). Leveraging a curated set of 332 LRGs derived from the literature, we identified prognosis-specific hepatocellular carcinoma (HCC) clusters through consensus clustering analysis. Using an integrated bioinformatics approach, we systematically evaluated differences in immune microenvironment infiltration, somatic mutations, copy number variations, and epigenetic modifications between the two tumor subtypes. We subsequently developed a lactylation-related genes signature (LRGS) and independently validated its prognostic efficacy in the TCGA cohort. Notably, the high-LRGS group exhibited significantly reduced overall survival(OS) and diminished response to ICIs. Conversely, the high-LRGS group demonstrated heightened sensitivity to several antitumor agents, including AZD5153, cediranib, foretinib, and vorinostat, relative to the low-LRGS group. Our findings establish a robust LRGS model, offering a clinically actionable tool for prognostic assessment and precision therapy in HCC.