VCAM1 expression is associated with prognosis and the immune context
VCAM1 abundance varied across tumor types rather than showing a universal increase. Relative to normal brain, glioma displayed a pronounced elevation (Figure 1A). Significant increases were found in glioblastoma (GBM) and lung adenocarcinoma (LUAD). Stomach adenocarcinoma (STAD) and esophageal carcinoma (ESCA) showed the same direction, as did head and neck squamous cell carcinoma (HNSC). The pattern was absent from pancreatic adenocarcinoma (PAAD), breast invasive carcinoma (BRCA), and several other cancers. The increase in VCAM1 was therefore context-dependent and especially evident in glioma.
Pan-cancer Cox analyses summarized the associations between VCAM1 abundance and overall survival (OS), disease-specific survival (DSS), and progression-free interval (PFI) as forest plots (Figure 1B–D). Immune analysis linked VCAM1 to macrophage, regulatory T-cell (Treg), and dendritic-cell infiltration (Figure 1E). Together, the pan-cancer outcome patterns and glioma immune profile supported further glioma-focused analyses.
Glioma samples contained more VCAM1 than normal brain samples in the direct tissue comparison (Figure 1F). Values rose across World Health Organization (WHO) grades and peaked in grade IV disease (Figure 1G). Relationships between VCAM1, clinicopathological variables, and molecular subtypes were visualized by the Sankey plot (Figure 1H). HPA immunohistochemistry (IHC) showed VCAM1-positive staining in representative glioma sections (Figure 1I). These images supplied qualitative protein evidence because they did not constitute a quantitative validation series. The magnitude and direction of these associations varied across tumor types; therefore, glioma-specific Kaplan-Meier curves are presented separately in Figure 2.

Figure 1: Clinical, expression, and immune features associated with VCAM1 in glioma. (A) TCGA pan-cancer comparison of VCAM1 abundance. (B–D) Forest plots summarizing pan-cancer associations between VCAM1 and overall survival (OS), disease-specific survival (DSS), and progression-free interval (PFI), respectively. (E) Heatmap relating VCAM1 to immune-cell estimates. (F) Tumor-versus-normal brain comparison. (G) Distribution across World Health Organization (WHO) grades. (H) Sankey representation of VCAM1 and clinicopathological variables. (I) Representative VCAM1 immunohistochemistry (IHC) from HPA. Please click here to view a larger version of this figure.
High VCAM1 expression identifies a poor-outcome glioma subgroup
Kaplan-Meier estimates consistently favored patients with lower VCAM1 expression. For disease-specific survival (DSS), the high-expression group had HR = 2.09 (95% confidence interval [CI]: 1.61–2.71; p < 0.001; Figure 2A). Progression-free interval was likewise shorter, with PFI HR = 1.68 (95% CI: 1.36–2.09; p < 0.001; Figure 2B). Overall survival followed the same direction, with OS HR = 2.01 (95% CI: 1.57–2.57; p < 0.001; Figure 2C). Together, the three endpoints characterized high-VCAM1 glioma as a poor-outcome subgroup.
A receiver operating characteristic (ROC) curve was generated with OS as the endpoint. The area under the curve (AUC) for VCAM1 was 0.819 (95% CI: 0.752–0.886; Figure 2D), consistent with moderate discrimination in this dataset. At 1, 3, and 5 years, time-dependent AUCs were 0.635, 0.609, and 0.627, respectively (Figure 2E).
Model-predicted survival closely tracked observed survival at 1, 3, and 5 years in the calibration analysis (Figure 2F). The resulting nomogram combined VCAM1 expression and WHO grade with sex, age, and isocitrate dehydrogenase (IDH) status (Figure 2G).

Figure 2: Assessment of VCAM1 as a prognostic variable. (A–C) Kaplan-Meier estimates presented in the order disease-specific survival (DSS), progression-free interval (PFI), and overall survival (OS). (D) Receiver operating characteristic (ROC) analysis; the area under the curve (AUC) reached 0.819. (E) Performance was evaluated after 1, 3, and 5 years. (F) Agreement between modeled and observed survival. (G) Nomogram containing VCAM1, sex, age, World Health Organization (WHO) grade, and isocitrate dehydrogenase (IDH) status. Please click here to view a larger version of this figure.
VCAM1 expression is associated with immune-infiltration patterns
Deconvolution revealed multiple immune populations whose estimated abundance varied with VCAM1. Macrophages and eosinophils showed positive relationships. Neutrophils followed the same direction, while NK CD56bright cells were inversely related to VCAM1 (Figure 3A). High- and low-VCAM1 groups also differed in their stacked immune-composition profiles (Figure 3B). These results connected VCAM1 with the immune architecture of glioma.
Individual scatter plots quantified the immune relationships. Macrophage infiltration increased with VCAM1 (R = 0.499, p < 0.001; Figure 3C), as did eosinophil infiltration (R = 0.431, p < 0.001; Figure 3D). Conversely, NK CD56bright infiltration declined as VCAM1 increased (R = −0.338, p < 0.001; Figure 3E). Plasmacytoid dendritic cells (pDCs) showed a further moderate inverse relationship (R = −0.283, p < 0.001; Figure 3F).
VCAM1 expression was next compared with programmed cell death 1 ligand 2 (PDCD1LG2/PD-L2) expression. A strong positive correlation was observed in low-grade glioma (LGG; rho = 0.651, p < 2.2 × 10⁻16; Figure 3G). The association remained significant in glioblastoma (GBM), although it was weaker (rho = 0.42, p = 2.49 × 10⁻8; Figure 3H). This correlation across glioma grades associated VCAM1 expression with an immunosuppressive signaling marker.

Figure 3: Relationship of VCAM1 to the glioma immune compartment. (A) Immune-cell estimates correlated with VCAM1. (B) Stacked cellular composition for high- and low-VCAM1 groups. (C–F) Pairwise plots for selected immune subsets. (G–H) Association between VCAM1 and programmed cell death 1 ligand 2 (PDCD1LG2/PD-L2) in low-grade glioma (LGG) and glioblastoma (GBM). Please click here to view a larger version of this figure.
VCAM1-related genes are enriched in immune and inflammatory pathways
Transcriptome-wide correlations were used to place VCAM1 within broader biological programs. Genes on both sides of the correlation distribution were displayed in a volcano plot (Figure 4A). Separate heatmaps of representative genes distinguished low- from high-VCAM1 samples (Figure 4B, C), revealing coordinated transcriptional differences between these groups.
Gene Ontology (GO) results for the high-VCAM1 group emphasized leukocyte migration and cytokine-mediated signaling. Antigen processing and presentation were also prominent. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis supported the immune-pathway pattern (Figure 4D). Low-VCAM1 profiles instead emphasized neuronal communication, synaptic function, and metabolism. The pathway-level contrast paralleled the immune-deconvolution findings.

Figure 4: Transcriptional programs accompanying VCAM1 expression. (A) Volcano representation of VCAM1-correlated genes. (B–C) Representative heatmaps from the low- and high-VCAM1 groups. (D) Immune enrichment detected by Gene Ontology (GO) and supported by Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Please click here to view a larger version of this figure.
VCAM1 depletion changes cytokine output, invasion-associated markers, and apoptosis in glioma cells
VCAM1 was depleted using small interfering RNA (siRNA) to assess the effects on signaling, cytokine production, invasion-associated transcripts, and apoptosis in glioma cells. Phosphorylated p65, AKT, and ERK decreased after knockdown, while the corresponding total-protein amounts changed little (Supplementary Figure 1). Western blot analysis demonstrated reduced phosphorylation of p65, AKT, and ERK following VCAM1 knockdown. VCAM1 depletion, therefore, affected pathway activation more clearly than the total abundance of these survival- and inflammation-related proteins.
In both glioma cell lines, quantitative real-time PCR (qRT-PCR) revealed distinct cytokine profiles following VCAM1 depletion. IL-4, IL-10, and TNF-β transcripts declined, whereas IFN-γ increased (Figure 5A, B).
VCAM1 knockdown also reduced MMP2, MMP9, and N-cadherin transcripts while increasing E-cadherin in both U87 and U251 cells (Figure 5C, D). This shift is consistent with a less mesenchymal, invasion-associated transcriptional phenotype, although migration and invasion were not measured directly. VCAM1 silencing also increased the apoptotic fraction in U87 and U251 cultures (Figure 5E). More apoptotic events occurred with si-VCAM1 than with si-NC, consistent with a survival-supporting role for VCAM1 under these assay conditions (Supplementary Figure 2). Western blot analysis demonstrated reduced phosphorylation of p65, AKT, and ERK following VCAM1 knockdown.
Secreted cytokines changed in the same direction as their transcript measurements. Enzyme-linked immunosorbent assay (ELISA) showed lower IL-4, IL-10, and TNF-β, but higher IFN-γ, after VCAM1 knockdown (Figure 5F, G). Taken together with increased apoptosis and reduced phosphorylation of p65, AKT, and ERK, these data link VCAM1 to inflammatory activity and glioma cell survival.

Figure 5: Cellular consequences of VCAM1 depletion. (A–B) Quantitative real-time PCR (qRT-PCR) measurements of IL-4, IL-10, TNF-β, and IFN-γ in U251 and U87 cells. (C–D) qRT-PCR measurements of MMP2, MMP9, E-cadherin, and N-cadherin in U87 and U251 cells. (E) Apoptosis after VCAM1 knockdown, measured by flow cytometry. (F–G) Enzyme-linked immunosorbent assay (ELISA) measurements of secreted cytokines in U87 and U251 cells. Results derive from three independent experiments. Please click here to view a larger version of this figure.
DATA AVAILABILITY:
All bioinformatics datasets analyzed in this study were obtained from publicly available resources, including The Cancer Genome Atlas (TCGA), the Genotype-Tissue Expression (GTEx) project, LinkOmics, and the Human Protein Atlas (HPA; ENSG00000162692). No new clinical, sequencing, genomic, or transcriptomic datasets were generated. The raw experimental data supporting the qRT-PCR, ELISA, flow cytometry, and western blot analyses are provided as Supplementary File 1.
Supplemental File 1: Raw dataset supporting the VCAM1-based prognostic nomogram. This file contains the de-identified, patient-level raw data underlying all analyses presented in the manuscript. Please click here to download this file.
It includes:
- Baseline clinicopathological variables for every enrolled patient (e.g., age, sex, tumor stage, histologic grade, and treatment regimen)
- VCAM1 expression measurements (e.g., immunohistochemical staining scores / quantitative expression values) used as the core biomarker predictor;
- Follow-up and outcome data, including survival time and survival status (overall survival and/or progression-free survival), together with the event indicator;
- Nomogram-derived predicted risk scores and the corresponding observed outcomes used to construct the ROC curves, calibration plots, and the decision curve analysis (DCA) presented in the main text and Supplementary Figure 1.
Supplementary Figure 1: Decision curve analysis of the VCAM1-based prognostic model. (A) Decision curve analysis showing the net clinical benefit of the prognostic model across a range of threshold probabilities. (B) One representative blot from three independent experiments is presented. Approximate expected sizes are 90 kDa for VCAM1, 65 kDa for p65, 60 kDa for AKT, 44/42 kDa for ERK1/2, and 36 kDa for GAPDH. U87 and U251 designations are used consistently. Please click here to download this file.
Supplementary Figure 2: xCell-based immune infiltration analysis according to VCAM1 expression in glioma. (A) Macrophage xCell scores in the high- and low-VCAM1 expression groups. (B) Regulatory T-cell (Treg) xCell scores in the high- and low-VCAM1 expression groups. Statistical significance was determined using the Wilcoxon rank-sum test. Please click here to download this file.