Background: Sorting nexin-20 (SNX20) is a member of the sorting nexin family of proteins. It plays a crucial role in the regulation of innate immunity. However, the prognostic risk, potential mechanisms, immunotherapy, and other functions of SNX20  in lung adenocarcinoma (LUAD) remain unclear.
Methods: We analyzed and validated the expression and prognostic role of SNX20  in LUAD through a combination of The Cancer Genome Atlas, Gene Expression Omnibus, Oncomine, TIMER, and Human Protein Atlas databases. Further, we analyzed the correlation between SNX20  expression and clinical characteristics of LUAD, and the prognostic value of SNX20  in LUAD was evaluated. Using fitted SNX20 expression and other clinical parameters, a predictive model with predictive performance for the overall survival of patients with LUAD was constructed. The potential biological function of SNX20  in LUAD was explored using gene set enrichment analysis. In addition, we analyzed the correlation between SNX20  expression and the immune microenvironment and survival.
Results: SNX20  was downregulated in most cancer types, was associated with poor prognosis in LUAD and could be an independent prognostic factor for patients with LUAD. The predictive model developed by us had good predictive power for determining the overall survival of patients with LUAD. Biofunctional analysis revealed that genes co-expressed with SNX20  mainly promoted the immune process and inhibited the cell proliferation process in LUAD. We observed that high expression of SNX20  was accompanied by a better immune microenvironment and survival in patients with LUAD. Furthermore, the LUAD immune response was elevated with an increase in SNX20  expression. Finally, we found that SNX20  expression was significantly associated with various tumor-infiltrating immune cells, and it was widely involved in regulating various immune molecules in LUAD and affecting immune infiltration in the tumor microenvironment.
Conclusion: Our results suggested that SNX20  is a potential immune-related biomarker and therapeutic target associated with the prognosis of patients with LUAD. This provided a new strategy for the development of immunotherapeutic and prognostic markers in LUAD.
Keywords: SNX20 , biomarkers, lung adenocarcinoma, prognosis, immune infiltration