Comprehensive analysis of hypoxia-related genes for prognosis, immune features, and drugs treatment strategy in gastric cancer using bulk and single-cell RNA-sequencing

Hypoxia is one of the malignant characteristics of solid tumors and is related to the multiple malignant characteristics of the tumor. No study has not yet reported a systematical analysis of the characteristics of hypoxia from single-cell resolution in gastric cancer. In our research, we investigated the hypoxia features of various types of cells in single-cell resolution, identified hypoxia-related genes by the weighted gene co-expression network analysis method. Through the hypoxia-related genes from single-cell levels, we screened out 13 genes and established a prognostic model. This model performs well in the training dataset and multiple independent verification data sets. We thought that tumor hypoxia might affect the DNA methylation of cells and promote the transcription of genes associated with malignant features, thereby promoting tumor progression. We found that the more tumor associated genes in the high-risk group showed hypomethylation and high hypoxia-risk score group have more tumor-related genes, more immunosuppressive immune cells and more enrichment of cancer -related pathways. The lower risk group is more sensitive to three chemotherapy drugs for gastric cancer. Our study illustrates the crucial role of hypoxia in gastric cancer. Hypoxia-related gene prognostic model has been established and has good performance. Hypoxia-related risk score can also be used to guide a patient’s drug treatment strategy.