Integrative pan-cancer analysis reveals AARS2 as a lactylation-associated biomarker and therapeutic target in colon adenocarcinoma.

Background: Colon adenocarcinoma (COAD) is a lethal malignancy with a poor prognosis. The tumor microenvironment (TME) is pivotal in its development, within which lactate accumulation is a common metabolic hallmark. Lactylation, a novel post-translational modification driven by lactate, serves as a crucial link between tumor metabolism and immunosuppression. It plays multifaceted roles in promoting malignant progression, immune evasion, and chemoresistance. Therefore, systematically investigating lactylation and identifying its key mediators may yield novel therapeutic targets and strategies for COAD. Methods: We performed an integrative multi-omics analysis of lactylation-related genes (LRGs) in COAD and pan-cancer cohorts, leveraging bulk RNA-seq, single-cell RNA-seq, and spatial transcriptomic data from public repositories including TCGA and GEO. A curated set of 160 LRGs was investigated using a multi-step machine learning framework, integrating Cox regression, time-dependent ROC analysis, and optimal risk stratification to construct robust prognostic signatures, which collectively identified AARS2 as a pivotal candidate. Subsequent multi-faceted oncogenic characterization of AARS2 encompassed its expression profiles, diagnostic and prognostic value, and associations with tumor microenvironment heterogeneity. To validate AARS2 at the protein level, we first interrogated the HPA database and subsequently confirmed its expression using immunohistochemistry (IHC) on an independent cohort of clinical COAD specimens. To further elucidate AARS2's functional role in COAD pathogenesis and its potential linkage to lactylation biology, Results: Integrative multi-omics analyses identified AARS2 as significantly upregulated in COAD and multiple malignancies, with elevated expression correlating with adverse clinical outcomes. Single-cell and spatial transcriptomic profiling indicated predominant enrichment of AARS2 in malignant cell populations and association with immunosuppressive microenvironment features. Functional enrichment suggested potential involvement in epithelial-mesenchymal transition, hypoxia response, and cell cycle pathways. Immunohistochemical validation in clinical COAD specimens confirmed higher AARS2 protein levels in tumor tissues versus adjacent normal mucosa; concurrent elevation of cGAS protein was observed, though functional activity requires contextual interpretation. Conclusion: AARS2 correlates with lactylation dynamics, metabolic features, and immune modulation in COAD, suggesting a potential role in lactylation-associated cGAS-STING pathway regulation. These correlative observations warrant rigorous mechanistic validation to define causality and assess translational potential.