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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Oncol. Nov 15, 2026; 18(11): 124110
Published online Nov 15, 2026. doi: 10.4251/wjgo.124110
Fatty acid desaturase 1 drives esophageal cancer via M1 macrophage ferroptosis and lipid metabolism remodeling
Qian-Cheng Du, Yu Bai, De-Hua Zhou, Hua Yu, Hui Nian
Qian-Cheng Du, Hui Nian, Department of Thoracic Surgery, Shanghai Xuhui Central Hospital, Shanghai 200031, China
Yu Bai, Intensive Care Unit, Shanghai Xuhui Central Hospital, Shanghai 200031, China
De-Hua Zhou, Department of Gastrointestinal Surgery, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai 200434, China
Hua Yu, Department of Plastic Surgery, Shanghai Baoshan District Wusong Central Hospital, Shanghai 200940, China
Co-corresponding authors: Hua Yu and Hui Nian.
Author contributions: Du QC, Yu H, and Nian H contributed to writing the original draft; Du QC, Zhou DH, Yu H, and Nian H contributed to conceptualization; Du QC, Bai Y, Yu H, and Nian H contributed to investigation and validation; Du QC contributed to methodology; Bai Y, Yu H, and Nian H contributed to formal analysis; Zhou DH, Yu H, and Nian H contributed to writing - review and editing; Yu H and Nian H contributed to software, visualization, supervision, project administration, resources, and they contributed equally to this manuscript as co-corresponding authors. All the authors approved the final manuscript.
AI contribution statement: No artificial intelligence tools were utilized in the drafting, analysis, figure generation or revision of this manuscript.
Institutional review board statement: The protocol for the use of human tissue samples in this study was reviewed and approved by the Ethics Committee of Shanghai Xuhui Central Hospital, approval No. (2022) prereview (060) 001.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are available from the corresponding authors upon reasonable request.
Corresponding author: Hui Nian, MD, Department of Thoracic Surgery, Shanghai Xuhui Central Hospital, No. 366 Longchuan North Road, Xuhui District, Shanghai 200031, China. hnian14@fudan.edu.cn
Received: June 8, 2026
Revised: July 14, 2026
Accepted: August 28, 2026
Published online: November 15, 2026
Processing time: 140 Days and 15.9 Hours
Core Tip

Core Tip: Esophageal cancer patients have a poor prognosis with unclear immunometabolic mechanisms. Fatty acid desaturase 1 (FADS1), a key lipid metabolism enzyme, is linked to multiple cancers, but its role in esophageal cancer immunity is unknown. In this study, FADS1, which is overexpressed in tumor-infiltrating M1 macrophages, was identified as a causal factor for esophageal cancer. Mechanistically, FADS1 accumulates 1-palmitoyl-2-stearoyl-glycerophosphocholine, promotes lipid raft assembly, and triggers ferroptosis in M1 macrophages, impairing their antitumor function. Inhibiting FADS1 expression suppressed ferroptosis and restored M1 macrophage activity. The FADS1 inhibitor BRD-K95779464 was identified by artificial intelligence screening. This work reveals a novel FADS1-mediated immunometabolic pathway in esophageal cancer.

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