Prognostic value of neuro-related genes in colorectal cancer and their potential implications for immunotherapy.

Colorectal cancer (CRC) remains a leading cause of cancer mortality. This study investigates the prognostic and immunological role of neural-related genes (NRGs) in CRC. Using The Cancer Genome Atlas (TCGA) data, a four-gene signature (POU4F1, KLC3, ATP2A1, CALB2) was constructed via Cox and least absolute shrinkage and selection operator (LASSO) regression. This signature independently predicted patient survival. High-risk patients showed enrichment in cytokine signaling and oxidative phosphorylation. Importantly, CALB2 expression correlated with increased infiltration of NKT and central memory CD4+ T cells, while high-risk scores were associated with greater potential for immune evasion. Single-cell analysis revealed epithelial cells as the primary source of these NRGs. This NRG-based signature provides a novel biomarker for prognosis and immunotherapy optimization in CRC.