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Original Article | Open Access

Lactate Dehydrogenase A and a Novel Four‐Gene Signature as Dual Diagnostic Markers for Lung Adenocarcinoma and Ischemic Stroke

Jin Xie1Gao‐Chun Xiao2Xin‐Yang Qu3Rui‐Min Wu4Yu‐Long Zou5Xue Hu6Xu‐Sheng Liu4 ( )
Department of Rehabilitation Medicine Center, Taihe Hospital, Hubei University of Medicine, Shiyan, China
Department of General Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
School of Basic Medical Sciences, Hubei University of Medicine, Shiyan, China
Department of Nuclear Medicine, Hubei Provincial Clinical Research Center for Precision Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, China
Department of Finance, Taihe Hospital, Hubei University of Medicine, Shiyan, China
Institute of Medicine Nursing, Hubei University of Medicine, Shiyan, China

Jin Xie, Gao‐Chun Xiao, and Xin‐Yang Qu contributed equally to this work.

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Abstract

Background

Lung adenocarcinoma (LUAD) and ischemic stroke (IS) are major global health challenges that share underlying molecular mechanisms; however, the extent of this overlap remains unclear. This study explores gene expression changes and protein interactions that link these two conditions to identify diagnostic biomarkers and to examine the role of lactate dehydrogenase A (LDHA) in LUAD progression.

Methods

Transcriptomic data from The Cancer Genome Atlas LUAD dataset, the Gene Expression Omnibus GSE146882 IS dataset, and, for validation, the GSE31210 LUAD dataset were subjected to differential expression analysis using DESeq2 and limma packages. Differentially expressed genes that were common between the LUAD and IS datasets were analyzed through protein‐protein interaction network construction and machine learning algorithms (Support Vector Machine and Random Forest) to identify diagnostic biomarkers. Diagnostic accuracy was assessed using receiver operating characteristic curve analysis. For LUAD, prognostic significance was determined through Cox regression analysis, and immune infiltration patterns were characterized using the CIBERSORT algorithm. Associations with N6‐methyladenosine modification genes and cell cycle regulators were analyzed through correlation studies.

Results

Eighty‐five upregulated genes were common between LUAD and IS tissues, among which 49 hub genes were identified through protein‐protein interaction analysis. Machine learning selected a four‐gene signature, LDHA, NME4, SLC25A39, and SLC7A5, which showed high diagnostic accuracy. In LUAD, LDHA was the only independent prognostic factor linked to poor survival. Furthermore, LDHA expression was positively correlated with key N6‐methyladenosine modification genes and cell cycle regulators and was linked to a distinct pro‐inflammatory immune infiltration pattern.

Conclusions

We have identified LDHA and three additional hub genes as disease‐agnostic diagnostic biomarkers in LUAD and IS. The independent prognostic significance of LDHA and its broad mechanistic involvement establish it as a potential therapeutic target for LUAD management. Further investigation of LUAD–IS comorbidity mechanisms is warranted.

Graphical Abstract

This study identified shared molecular alterations between lung adenocarcinoma (LUAD) and ischemic stroke (IS) through integrative transcriptomic analysis of TCGA‐LUAD and GSE146882 datasets, revealing a four‐gene diagnostic signature (LDHA, NME4, SLC25A39, and SLC7A5) with high accuracy across both diseases. Among these, LDHA was further identified as the only independent prognostic factor in LUAD using TCGA‐LUAD and GSE31210 cohorts. Correlation analyses suggested that elevated LDHA expression is associated with m6A‐related gene patterns, increased cell cycle activity, and a pro‐inflammatory immune microenvironment in LUAD. These findings establish a cross‐disease diagnostic framework while highlighting LDHA as a potential contributor to LUAD progression and a candidate therapeutic target.

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Medicine Advances
Pages 206-221

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Cite this article:
Xie J, Xiao G, Qu X, et al. Lactate Dehydrogenase A and a Novel Four‐Gene Signature as Dual Diagnostic Markers for Lung Adenocarcinoma and Ischemic Stroke. Medicine Advances, 2026, 4(2): 206-221. https://doi.org/10.1002/med4.70069

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Received: 27 November 2025
Revised: 28 January 2026
Accepted: 09 April 2026
Published: 27 May 2026
© 2026 The Author(s). Tsinghua University Press.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.