COL11A1 promotes lung adenocarcinoma progression via PI3K/AKT/mTOR pathway: mechanistic insights and development of a COL11A1-related prognostic signature.

[BACKGROUND] Lung cancer is the leading cause of cancer-related deaths worldwide. Lung adenocarcinoma (LUAD) accounts for 40% of all lung cancer cases, with a 5-year survival rate of less than 20%. Delayed diagnosis, high recurrence rate, and drug resistance are the main factors contributing to its poor prognosis. Collagen type XI alpha 1 chain (COL11A1) has been shown to promote tumor invasion and metastasis in various malignant tumors; however, its expression regulatory mechanism and biological function in LUAD remain unclear. This study aimed to investigate the effect of COL11A1 on LUAD progression and its underlying molecular mechanism, and to construct a relevant prognostic evaluation model, thereby providing a basis for the diagnosis and treatment of LUAD.

[METHODS] The expression characteristics of COL11A1 were determined through multi-omics analysis of public datasets (TCGA_LUAD, GSE series) and clinical specimens. Western blot, chromatin immunoprecipitation (ChIP), and luciferase reporter gene assays were used to elucidate the regulatory mechanism of COL11A1. COL11A1-related risk score (CRRS) and a nomogram were constructed based on LASSO-Cox regression analysis, followed by validation in multiple cohorts.

[RESULTS] COL11A1 expression was significantly upregulated in LUAD tissues, and its high expression was closely associated with poor prognosis of LUAD patients, with an area under the receiver operating characteristic curve (AUC) > 0.93. and experiments confirmed that COL11A1 could promote the proliferation of LUAD cells by activating the PI3K/AKT/mTOR signaling pathway. The transcription factor TWIST positively regulated COL11A1 expression by directly binding to its promoter region. The CRRS constructed based on 7 core genes successfully stratified patients in both the training and validation cohorts into high-risk and low-risk groups, with significant differences in survival rates between the two groups. Additionally, CRRS was correlated with drug sensitivity. The nomogram integrating CRRS and clinical variables effectively predicted the 1-year, 3-year, and 5-year survival rates of LUAD patients (AUC > 0.71).

[CONCLUSIONS] COL11A1 acts as an oncogene in LUAD. Its expression is transcriptionally activated by the transcription factor TWIST, and it exerts pro-tumor effects by activating the PI3K/AKT/mTOR signaling pathway. CRRS and the nomogram provide potential references for prognostic evaluation and precision treatment of LUAD patients.