Background::5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/
IMP cyclohydrolase(ATIC) is a 64-kDa bifunctional enzyme, 5-aminoimidazole-
4-carboxamide ribonucleotide formyltransferase (AICART) and IMP cyclohydrolase,
respectively. catalyzes the last two steps of the purine ab initio biosynthetic pathway.
ATIC has been implicated in cancer progression, but its pan-cancer profile and specific
prognostic utility in liver hepatocellular carcinoma (LIHC) remain incompletely defined.
Methods::We analyzed TCGA RNA-seq data across 33 tumor types to assess ATIC
expression, diagnostic performance (ROC/AUC), and prognostic associations (OS,
DSS, PFI). We correlated ATIC expression with immune infiltration, TMB, MSI, and
predicted neoantigen load, and constructed a LIHC-specific prognostic nomogram
integrating ATIC and clinicopathologic features. Enrichment analyses (STRING,
GO/KEGG, GSEA) and pharmacogenomic correlations (GDSC, CTRP) were
performed to explore mechanisms and drug sensitivities.
Results::ATIC was significantly upregulated in 16 tumor types, including LIHC
(p<0.001). Pan-cancer ROC analyses showed high diagnostic accuracy in several
cancers (examples: CHOL AUC=1.000, LIHC AUC=0.936, LUAD AUC=0.947). High
ATIC expression associated with poorer OS in ACC, HNSC, LIHC, and PAAD (eg,
LIHC: HR=1.39(1.04-1.85), p=0.028). In LIHC, ATIC correlated with advanced T stage,
higher grade, elevated AFP, and shorter OS. Multivariable Cox regression identified
ATIC expression and pathological T stage as independent predictors; time-dependent
ROC for the LIHC nomogram showed AUCs of 0.711, 0.649, and 0.653 at 1, 3, and 5
years, respectively. GSEA indicated enrichment of PI3K–AKT–mTOR, MYC targets,
and cell-cycle pathways in ATIC-high LIHC. High ATIC expression correlated with
predicted increased sensitivity to sorafenib, doxorubicin, cisplatin, epothilone, and
mitomycin in the TCGA-LIHC cohort.
Discussion::ATIC upregulation across cancers links to tumor progression, immune
modulation, and prognosis (LIHC), suggesting oncogenic roles in pan-cancer contexts.
TCGA multi-omics show ATIC associates with immune/molecular subtypes,
MSI/TMB/neoantigens, and predicts drug sensitivity, indicating diagnostic/prognostic
potential.
Conclusion::ATIC is broadly upregulated across cancers and functions as an
independent prognostic biomarker in LIHC. The ATIC-integrated nomogram shows
modest predictive accuracy for LIHC survival. Our results implicate ATIC in oncogenic
signaling (PI3K–AKT–mTOR, MYC, and cell-cycle) and suggest ATIC as a candidate
biomarker to guide targeted and chemotherapeutic strategies in LIHC. Further in vitro
and in vivo validation is warranted.