ORIGINAL RESEARCH article
Front. Mol. Biosci.
Sec. Molecular Diagnostics and Therapeutics
This article is part of the Research TopicCancer Biomarkers: Molecular Insights into Diagnosis, Prognosis, and Risk Prediction: Volume IIView all 16 articles
Integrative Transcriptomic Profiling of Tumor Patients in Surgical ICU: Identifying Prognostic Immune Signatures
Provisionally accepted
- 1First Affiliated Hospital of Gannan Medical University, Nanchang, China
- 2First Affiliated Hospital of Gannan Medical University, Ganzhou, China
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Prognostic assessment of tumor patients in the surgical intensive care unit (SICU) remains challenging due to the complex interplay between systemic inflammation and immune dysfunction. In this study, we performed integrative transcriptomic profiling of peripheral blood mononuclear cells (PBMCs) from 112 SICU patients with solid tumors, aiming to identify immune-related signatures predictive of 30-day survival. High-throughput RNA sequencing quantified 19,832 expressed genes, while computational immune deconvolution using CIBERSORTx estimated relative fractions of 22 immune cell types. Differential expression analysis revealed 432 upregulated and 287 downregulated genes in non-survivors, with notable elevation of CXCL10 (27.5 ± 4.6 TPM vs. 12.3 ± 3.1 TPM in survivors, p=0.002) and IL6 (19.4 ± 3.9 vs. 9.1 ± 2.7 TPM, p=0.004), accompanied by reduced CD8A (12.3 ± 3.6 vs. 28.1 ± 4.2 TPM, p=0.006) and GZMB (7.2 ± 1.9 vs. 15.4 ± 3.0 TPM, p=0.008). Correspondingly, high-risk patients demonstrated decreased cytotoxic T lymphocyte fractions (12.3 ± 3.6% vs. 27.8 ± 4.2%, p = 2.6 × 10⁻ ⁴ ) and NK cells (5.2 ± 1.3% vs. 11.1 ± 2.1%, p = 1.9 × 10⁻ ⁴ ) with increased neutrophils (45.2 ± 5.1% vs. 31.7 ± 4.8%, p = 3.2 × 10⁻ ⁴ ). A Prognostic Immune Score (PIS), constructed based on 12 key immune-related genes, achieved a concordance index of 0.81, effectively stratifying patients into high-and low-risk groups with 30-day survival rates of 42.5% and 86.1%, respectively (log-rank p<0.001). Subgroup analyses confirmed that the PIS retained predictive accuracy across tumor types and APACHE II strata, underscoring its robustness. These findings demonstrate that integrative transcriptomic and immune profiling provides a quantitative framework for early risk stratification in SICU tumor patients and identifies actionable biomarkers for potential immunomodulatory interventions.
Keywords: immune signatures, Prognostic biomarkers, Surgical intensive care unit, Transcriptomics, tumor immunity
Received: 27 Dec 2025; Accepted: 11 Feb 2026.
Copyright: © 2026 Chen, Zhong, Ouyang, Lai and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chaoyu Wu
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