Oncogenic metabolic reprogramming contributes to tumor growth and immune evasion. The intertumoral metabolic heterogeneity and interaction of distinct metabolic pathways may determine patient outcomes. In this study, we aim to determine the clinical and immunological significance of metabolic subtypes according to the expression levels of genes related to glycolysis and cholesterol-synthesis in bladder cancer (BCa). | Zhang et al. BMC Cancer 2022 22 2 https s12885-021-09064-0 RESEARCH Open Access Alteration in glycolytic cholesterogenic gene expression is associated with bladder cancer prognosis and immune cell infiltration Yuying Zhang1 2 Baoyi Zhu1 Yi Cai3 Sihua Zhu1 Hongjun Zhao1 Xiaoling Ying4 Chonghe Jiang1 and Jianwen Zeng1 Abstract Background Oncogenic metabolic reprogramming contributes to tumor growth and immune evasion. The intertu- moral metabolic heterogeneity and interaction of distinct metabolic pathways may determine patient outcomes. In this study we aim to determine the clinical and immunological significance of metabolic subtypes according to the expression levels of genes related to glycolysis and cholesterol-synthesis in bladder cancer BCa . Methods Based on the median expression levels of glycolytic and cholesterogenic genes patients were stratified into 4 subtypes mixed cholesterogenic glycolytic and quiescent in an integrated cohort including TCGA GSE13507 and IMvigor210. Clinical genomic transcriptomic and tumor microenvironment characteristics were compared between the 4 subtypes. Results The 4 metabolic subtypes exhibited distinct clinical molecular and genomic patterns. Compared to quies- cent subtype mixed subtype was more likely to be basal tumors and was significantly associated with poorer prog- nosis even after controlling for age gender histological grade clinical stage and molecular phenotypes. Additionally mixed tumors harbored a higher frequency of RB1 and LRP1B copy number deletion compared to quiescent tumors vs. and vs. respectively both adjusted P valueZhang et al. BMC Cancer 2022 22 2 Page 2 of 15 were diagnosed with BCa in 2020 with 212 000 BCa- subtypes through heterogeneity in distinct metabolic related deaths in that year posing an enormous threat pathways to enhance personalized therapy. to human health 2 . In recent times BCa treatment In this study we stratified BCa into 4 distinct metabolic has
