Prognostic model for colorectal cancer based on folic acid metabolism-related genes reveals immune landscape

BACKGROUND: Colorectal cancer (CRC) is a common malignant tumor with high invasiveness and mortality. Folic acid metabolism-related genes (FAMGs) are critical for DNA synthesis and repair, but their roles in CRC initiation and progression remain unclear. METHODS: TCGA-COAD/READ datasets served as the training set, and GSE38832 as the validation set. CRC was molecularly subtyped via FAMGs expression. Prognostic genes were identified through LASSO regression, and univariate/multivariate Cox analyses, with a prognostic model constructed. Immune infiltration was assessed using CIBERSORT, ssGSEA, and ESTIMATE, and molecular mechanisms explored via GSEA, GO, and KEGG. RESULTS: Three CRC subgroups with distinct biological functions and immune heterogeneity were identified. Six FAMGs highly expressed in CRC were used to build a prognostic model. High-risk groups showed lower immune cell infiltration, and upregulated DEGs between risk groups were enriched in the Wnt signaling pathway. CONCLUSION: This study explores FAMGs' roles in CRC's tumor microenvironment and molecular mechanisms, providing new insights for CRC's pathological research and treatment strategies.