Alternative splicing implicated in immunity and prognosis of colon adenocarcinoma

Dysregulation of immune system is the hallmark of colon adenocarcinoma (COAD) patients. Aberrant alternative splicing (AS) is closely related to progression and immunotherapy of COAD. However, the intrinsic correlation of immune system with AS have not been elucidated. Here we identified 640 AS events related to immunescore by multi-omics data analysis. 7 key AS events were screened out and used to develop a riskscore model, the area under the ROC curve of riskscore model predicting 3-, 5-year survival probability was 0.750, 0.768. Also, the riskscore based on 7 key AS events is an independent prognostic factor. The AUC of the nomogram composed of riskscore and TMN grade reached to 0.872(3-year) and 0.841(5-year). Moreover, 11 AS events were identified to be associated with the infiltration of 8 types of immune cells. Interestingly, M1 macrophages and memory B cells had a higher infiltration in high-riskscore patients, and higher infiltration of M1 macrophages and memory B cells were significantly associated with worse prognosis. In conclusion, AS are closely related to immunescore, immunity stage and infiltrating immune cells. The riskscore is an effective diagnostic and prognostic indicator better than TMN grade, and AS events related to the immune system may be potential therapeutic targets for COAD.