This study aims to develop fatty acid metabolism-related molecular subtypes and construct a fatty acid metabolism-related novel model for bladder cancer (BCa) by bioinformatic profiling. Genome RNA-seq expression data of BCa samples from the TCGA database and GEO database were downloaded. We then conducted consensus clustering analysis to identify fatty acid metabolism-related molecular subtypes for BCa. Univariate and multivariate Cox regression analysis were performed to identify a novel prognostic fatty acid metabolism-related prognostic model for BCa. Finally, we identified a total of three fatty acid metabolism-related molecular subtypes for BCa. These three molecular subtypes have significantly different clinical characteristics, PD-L1 expression levels, and tumor microenvironments. Also, we developed a novel fatty acid metabolism-related prognostic model. Patients with low-risk score have significantly preferable overall survival compared with those with high-risk score in the training, testing, and validating cohorts. The area under the ROC curve (AUC) for overall survival prediction was 0.746, 0.681, and 0.680 in the training, testing and validating cohorts, respectively. This model was mainly suitable for male, older, high-grade, cluster 2–3, any TCGA stage, any N-stage, and any T-stage patients. Besides, we selected FASN as a hub gene for BCa and further qRT-PCR validation was successfully conducted. In conclusion, we developed and successfully validated a novel fatty acid metabolism-related prognostic model for predicting outcome for BCa patients.

本研究旨在开发脂肪酸代谢相关的分子亚型，并通过生物信息学分析构建脂肪酸代谢相关的膀胱癌（BCa）新模型。从TCGA数据库和GEO数据库下载BCa样本的基因组RNA-seq表达数据。然后，我们进行了共识聚类分析，以确定 BCa 的脂肪酸代谢相关分子亚型。进行单变量和多变量 Cox 回归分析以确定一种新型的 BCa 预后脂肪酸代谢相关预后模型。最后，我们总共鉴定了三种与脂肪酸代谢相关的 BCa 分子亚型。这三种分子亚型具有显着不同的临床特征、PD-L1表达水平和肿瘤微环境。此外，我们还开发了一种新型的脂肪酸代谢相关的预后模型。在训练、测试和验证队列中，与高风险评分的患者相比，低风险评分的患者具有明显更好的总体生存率。训练组、测试组和验证组中总体生存预测的 ROC 曲线下面积 (AUC) 分别为 0.746、0.681 和 0.680。该模型主要适用于男性、老年、高级别、2-3簇、任何TCGA分期、任何N分期和任何T分期患者。此外，我们选择FASN作为 BCa 的中心基因，并成功进行了进一步的 qRT-PCR 验证。总之，我们开发并成功验证了一种新型脂肪酸代谢相关预后模型，用于预测 BCa 患者的预后。