结直肠癌是美国癌症相关死亡的第二大原因。多组学方法有助于识别各种癌症特异性突变、表观遗传改变和细胞对化疗的反应。本研究旨在确定与结直肠癌生存相关的因素，并使用多组学方法开发和验证多基因生存评分系统（PSS）。数据来自癌症基因组图谱（TCGA）。结肠腺癌 (TCGA-COAD) 数据用于开发生存预测模型和 PSS，而直肠腺癌 (TCGA-READ) 数据用于验证 PSS。进行 Cox 比例风险回归分析来检查人口特征、临床变量和 mRNA 基因表达之间的关联。还评估了 PSS 的总体准确性。 TCGA-COAD 患者的中位总生存期为 7 年，TCGA-READ 患者的中位总生存期为 5 年。多变量 Cox 比例风险模型将年龄、癌症分期和九个基因的表达确定为结肠癌生存的预测因子。根据中位 PSS 0.38，48% 的 TCGA-COAD 患者具有高死亡风险。低风险组患者的 5 年生存率显着高于高风险组患者 (p <0.0001)。 PSS 在预测结直肠癌生存方面表现出较高的总体准确性。这项研究整合了临床和转录组数据，以确定结直肠癌患者的生存预测因素。 PSS 是估计结直肠癌生存率的准确且有效的指标。因此，它可以作为未来结直肠癌研究的重要工具。© 2024 Maawadh et al.

Colorectal cancer is the second leading cause of cancer-related death in the United States. A multi-omics approach has contributed in identifying various cancer-specific mutations, epigenetic alterations, and cells response to chemotherapy. This study aimed to determine the factors associated with colorectal cancer survival and develop and validate a polygenic survival scoring system (PSS) using a multi-omics approach.Data were obtained from the Cancer Genome Atlas (TCGA). Colon Adenocarcinoma (TCGA-COAD) data were used to develop a survival prediction model and PSS, whereas rectal adenocarcinoma (TCGA-READ) data were used to validate the PSS. Cox proportional hazards regression analysis was conducted to examine the association between the demographic characteristics, clinical variables, and mRNA gene expression.Overall accuracy of PSS was also evaluated. The median overall survival for TCGA-COAD patients was 7 years and for TCGA-READ patients was 5 years. The multivariate Cox proportional hazards model identified age, cancer stage, and expression of nine genes as predictors of colon cancer survival. Based on the median PSS of 0.38, 48% of TCGA-COAD patients had high mortality risk. Patients in the low risk group had significantly higher 5-year survival rates than those in the high group (p <0.0001). The PSS demonstrated a high overall accuracy in predicting colorectal cancer survival.This study integrated clinical and transcriptome data to identify survival predictors in patients with colorectal cancer. PSS is an accurate and valid measure for estimating colorectal cancer survival. Thus, it can serve as an important tool for future colorectal cancer research.© 2024 Maawadh et al.