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Background:  Chondroitin sulphate synthase 3 ( CHSY3 ) is an important enzyme that regulates glycosylation, but it has not been reported in tumours. This study explored for the first time the oncological features of  CHSY3  in stomach adenocarcinoma (STAD).   Methods:  We analysed  CHSY3  expression in STAD through the Cancer Genome Atlas (TCGA) database and verified our findings by immunohistochemical staining and Western blot experiments. The prognostic value of  CHSY3  in STAD was analysed through the biological aspects of  CHSY3  in STAD, such as communal clinical follow-up survival data, methylation sites, tumour immune microenvironment (TIME) and immune cell surface checkpoints. Finally, the immune-evasion potential of  CHSY3  in STAD was assessed on the Tumor Immune Dysfunction and Exclusion (TIDE) website and immunohistochemical staining experiment.   Results:  CHSY3  overexpression in STAD was associated with a poor prognosis based on immunohistochemical staining and Western blot experiments. Multivariate Cox analysis suggested that  CHSY3  could be an independent prognostic risk factor. Pathway enrichment and TIME analysis demonstrated that  CHSY3  up-regulated mesenchymal activation and immune activation signals in STAD, while TIDE assessment revealed that the risk of immune evasion was significantly higher in the high  CHSY3  expression group than in the low  CHSY3  expression group. Risk model scores based on  CHSY3 -associated immune cell surface checkpoints also presented poor prognosis, and immune evasion was significantly higher in the high-risk group than in the low-risk group.   Conclusions:  This study analysed  CHSY3  from multiple biological perspectives and revealed that  CHSY3  can be a biomarker of poor prognosis and mediates the TIME immune-evasion status in STAD.

CHSY3 can be a Poor Prognostic Biomarker and Mediates Immune Evasion in Stomach Adenocarcinoma