PANK1 associates with cancer metabolism and immune infiltration in clear cell renal cell carcinoma: a retrospective prognostic study based on the TCGA database

Background: Identify key biomarkers to improve the clinical prognosis of patients with advanced and metastatic clear cell renal cell carcinoma (ccRCC) remains an important research topic. Recently, ccRCC has been regarded as a metabolic disease. Pantothenate kinase-1 (PANK1) has been shown to play an important regulatory role in global metabolism and associates with the pathogenesis of hepatocellular carcinoma. Therefore, we aimed to investigate the role of PANK1 in the prognosis of ccRCC and in metabolism and immunity. Methods: PANK1 messenger ribonucleic acid (RNA) expression patterns in ccRCC using The Cancer Genome Atlas (TCGA) database. The clinical prognostic significance of PANK1 in ccRCC and a Cox regression was performed to evaluate the clinical factors associated with prognosis with confounding factors adjusted. The signaling pathways related to PANK1 expression were identified by Gene Ontology (GO) investigation and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. The Tumor Immune Estimation Resource database was used to analyze the correlation between PANK1 and tumor-infiltrating immune cells. Results: A total of 539 ccRCC patients and corresponding clinical samples and data from TCGA were included in this analysis. Significant differences were observed in PANK1 expression levels between tumor tissues and adjacent normal tissues in both TCGA-Kidney Renal Clear Cell Carcinoma cohort (4.40 vs. 2.94, P<0.001). PANK1 expression was found to be correlated with pathological stage, histological grade, age, sex, and clinical prognosis. Specifically, the low expression of PANK1 was found to be closely related to poor overall survival ( OS), disease-specific survival (DSS), and the progression-free survival (PFS) in ccRCC patients. The receiver operating characteristic curve suggested that PANK1 could be a potential prognostic biomarker (area under the curve =0.880), and that the promoter methylation levels of PANK1 were correlated with clinical factors. Further, PANK1 expression was found to be associated with multiple immune cell types and correlated with the enrichment of these cells. Finally, we further investigated the role of PANK1 in tumor growth and mitochondrial metabolism using ccRCC cells. Conclusions: PANK1 correlates with ccRCC prognosis, tumor immune status and metabolism using the TCGA data. PANK1 might be a prognostic marker of clinical prognosis for ccRCC patients.