Construction of a novel prognostic model for pancreatic adenocarcinoma to predict prognosis and guide immunotherapy

Pancreatic adenocarcinoma (PAAD) remains one of the most lethal malignant tumors, with poor prognosis and limited treatment options. This study aims to explore the role of butyrate metabolism-related genes (BMRGs) in PAAD to improve diagnostic and prognostic strategies. The study analyzed PAAD based on transcriptomic and clinical data obtained from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. Through the construction of protein-protein interaction (PPI) networks and LASSO Cox regression, characteristic genes were selected to develop a risk model related to butyrate metabolism (BMRS). This model effectively divided patients into high BMRS and low BMRS groups. Kaplan-Meier (K-M) analysis showed a significant difference in overall survival rates between the two groups. ROC curves and nomograms including clinical features and BMRS demonstrated strong predictive capabilities. Functional enrichment analysis (including Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG)) revealed key pathways, such as pancreatic secretion and immune-related processes. Additionally, the two BMRS groups showed different immune cell infiltration patterns, and several potential therapeutic drugs were determined through drug sensitivity prediction. Co-expression network analysis further revealed 20 genes related to biological processes such as keratinization and nucleosome assembly. In summary, this study highlights the clinical significance of BMRGs in PAAD and provides new insights into risk stratification and potential targets for personalized treatment.