This study used public datasets and cell lines for analysis and validation and did not involve human participants or clinical tissue samples; therefore, ethics approval was not required.
Differential expression analysis in GSE99671 and CellAge intersection
Raw count data and sample grouping information for GSE99671 were obtained from GEO11,12. Eighteen pairs of osteosarcoma and matched normal samples were analyzed. Paired differential expression analysis was performed using DESeq2 with the design formula ~ pair_id + condition, where pair_id accounted for paired-individual effects and condition compared tumor tissue with normal tissue13. Genes with read counts of at least 10 in at least three samples were retained. Differential expression was defined as an adjusted P < 0.05, and a stricter threshold of adjusted P < 0.05 and |log2FC| ≥ 1 was applied for visualization. Differentially expressed genes were intersected with the 866 CellAge senescence genes after gene symbols were converted to uppercase14. Differential expression analysis was performed in R (version 4.3.2) using DESeq2 (version 1.40.2), and adjusted P values were calculated using the Benjamini-Hochberg method.
TARGET-OS cohort and prognostic modeling
TARGET-OS transcriptomic and clinical data were obtained from UCSC Xena15. Expression values for the 105 senescence-related differentially expressed genes were extracted. Eighty-five patients with complete survival time, survival status, and candidate gene expression data were included, with 27 death events. Standardized gene expression values were analyzed using univariate Cox regression16, Kaplan-Meier survival analysis, and time-dependent receiver operating characteristic (ROC) analysis17. LASSO Cox regression18, repeated LASSO stability analysis, and random survival forest modeling were used to assess selection stability and variable importance19. The integrated hub score and clinical-integrated ranking were calculated using the explicit binary criteria detailed below. Survival analyses were performed in R using the survival (version 3.5-7), timeROC (version 0.4), glmnet (version 4.1-8), and randomForestSRC (version 3.2.2) packages. For the univariate Cox screening of the 105 candidate genes, Benjamini-Hochberg false discovery rate (FDR) correction was applied, and genes with FDR < 0.05 were considered statistically significant.
Model preprocessing, PPARG grouping, and time-dependent ROC analysis
Among 85 patients with 27 deaths, genes with zero variance were excluded, missing candidate-gene expression values were median-imputed, and each candidate gene was z-score standardized. For Kaplan-Meier analysis, expression was dichotomized at the cohort median: values strictly above the median were assigned to the high-expression group and values at or below the median to the low-expression group (PPARG: n = 42 high and n = 43 low). Log-rank tests were two-sided. Time-dependent ROC analyses used timeROC with event cause = 1, marginal inverse-probability-of-censoring weighting, evaluation times of 365, 1,095, and 1,825 days, and iid = FALSE. To ensure larger marker values consistently indicate higher risk, standardized expression values were used for genes with positive Cox coefficients and multiplied by -1 for protective genes with negative coefficients.
LASSO and repeated LASSO
Cox LASSO was fitted with glmnet using family = "cox", alpha = 1, prior z-score standardization (therefore standardize = FALSE), five-fold cross-validation, type.measure = "deviance" and random seed 123. The primary coefficient solution used lambda.min. Stability analysis repeated the same five-fold cross-validation 300 times; repeat b used seed 1000 + b (b = 1,...,300). For each gene, selection frequency was the proportion of repeats with a nonzero coefficient at lambda.min; nonzero selection at lambda.1se was also recorded.
Random survival forest
A survival forest was fitted to all 105 standardized candidate genes with randomForestSRC (version 3.2.2), using seed 123, ntree = 1,000, importance = TRUE, and na.action = "na.impute". Package defaults were retained for survival data: log-rank splitting, mtry = 11 (the ceiling of the square root of 105 predictors), minimum terminal node size = 15, nsplit = 10 random split points, sampling without replacement with a 0.632 sampling fraction, and anti-split variable importance.
Integrated hub score
Each of the 105 CellAge-related differentially expressed candidate genes received one point for each of six binary criteria: (1) differential-expression/CellAge intersection membership (all candidates received this point because adjusted P < 0.05 was required before scoring); (2) nominal univariate Cox P < 0.05; (3) Kaplan-Meier log-rank P < 0.05; (4) mean 3- and 5-year time-dependent AUC ≥ 0.65; (5) lambda.min repeated-LASSO selection frequency at or above the 70th percentile across candidates and > 0; and (6) random-survival-forest importance at or above the 70th percentile across candidates and > 0. All criteria had equal unit weight, giving a hub score from 0 to 6; genes scoring ≥ 4 advanced to clinical adjustment (18 genes). Univariate Cox FDR values were also reported, and FDR < 0.05 was used to denote multiple-testing significance, but the prespecified scoring indicator used nominal P < 0.05.
Clinical-integrated ranking
After merging expression and clinical records, the adjusted analyses included 40 patients with complete covariate records and 13 deaths. The final score was the initial hub score plus one point for each of seven criteria: adjusted Cox P < 0.05, adjusted Cox P < 0.10, sensitivity Cox P < 0.05 after removing definitive surgery, sensitivity Cox P < 0.10, mean 3- and 5-year AUC ≥ 0.65, likelihood-ratio-test P < 0.10 for the clinical-plus-gene versus clinical-only model, and delta AIC < 0. Because the 0.05 and 0.10 thresholds were nested, a P < 0.05 contributed two points, thereby giving greater weight to clearly significant adjusted and sensitivity Cox evidence. The total range was 0 to 13; ties were resolved by the smaller adjusted Cox P value, followed by the larger mean 3-/5-year AUC. PPARG received all six initial points and all seven clinical integration points (13/13), ranking first. The C-index improvement was reported descriptively and was not assigned a score.
Clinical adjustment
Candidate hub genes were integrated with TARGET-OS clinical variables, including sex, age, disease status at diagnosis, primary tumor site, specific tumor region and definitive surgery. Forty patients with complete expression and clinical records, including 13 deaths, entered the clinical-adjusted analyses. Cox models containing only clinical variables were compared with models including clinical variables plus gene expression. C-index, Akaike information criterion (AIC), and likelihood ratio test P values were used to evaluate model improvement. Sensitivity analysis was performed after removing the surgery variable.
Functional enrichment and immune microenvironment analysis
TARGET-OS samples were stratified according to PPARG expression. Differential expression between the PPARG-high and PPARG-low groups was used to generate ranked gene lists for gene set enrichment analysis (GSEA)20. The pathways displayed were Nemeth Inflammatory Response LPS Up, Burton Adipogenesis 5, Burton Adipogenesis 6, Krieg KDM3A Targets Not Hypoxia, Reactome: Transcriptional Regulation By TP53, Fulcher Inflammatory Response Lectin Vs LPS Dn, Hollmann Apoptosis Via CD40 Dn, Zhou Inflammatory Response Live Dn, WP: Fatty Acids And Lipoproteins Transport In Hepatocytes, Sweet Lung Cancer KRAS Up, KEGG Medicus Pathogen HIV Tat To TLR2/4 NF-kB Signaling Pathway and Reactome: Fatty Acids. A bulk CellAge senescence score was calculated, and Spearman correlation analysis was used to assess associations between PPARG and senescence genes or immune microenvironment signatures21. Differences in microenvironment scores between PPARG-high and PPARG-low groups were evaluated using non-parametric tests with multiple-testing correction.
Single-cell transcriptomic analysis
A published human osteosarcoma single-cell transcriptomic dataset was analyzed using a preprocessed object for which quality control, dimensionality reduction, clustering, and manual annotation had already been completed22,23,24. A total of 68,336 cells and 32,297 genes were included. For main-text interpretation, annotations were simplified into 13 major cell types: B cells, CAFs, cycling cells, endothelial cells, erythroid cells, macrophages/monocytes, malignant osteosarcoma cells, myogenic cells, neutrophils, osteoclast-like cells, pericytes, T/NK cells, and tumor-associated stromal cells. Dimensionality reduction, feature expression, dot, and violin plots were used to visualize PPARG localization. PPARG-positive cells were defined as cells with expression greater than zero. Differences among cell types were assessed using Kruskal-Wallis and Wilcoxon rank-sum tests with Benjamini-Hochberg correction. Single-cell analyses were performed in R using Seurat (version 5.0.1).
Spatial transcriptomic analysis
The SP_BS3 spatial transcriptomic sample was used to construct a spatial expression object25,26. Quality control thresholds were nFeature_Spatial ≥ 200 and percent.mt ≤ 30, leaving 4,572 spots for analysis. Data were normalized, 3,000 highly variable genes were selected, and data scaling, principal component analysis, neighborhood graph construction, spatial spot clustering, and dimensionality reduction were performed. A spatial CellAge senescence score was calculated after removing PPARG from the gene set to avoid circular correlation. Endothelial, pericyte, macrophage/monocyte, tumor-associated stromal, malignant osteosarcoma, and osteoclast-like signatures were constructed and scored. Spearman correlation analysis was used to assess associations between PPARG expression and spatial scores. Label transfer was performed using the single-cell dataset as the reference and the spatial dataset as the query to infer predicted cell-type scores for each spot23,24. Spatial transcriptomic analyses were performed in R using Seurat (version 5.0.1), and Benjamini-Hochberg FDR correction was applied to all spatial correlation P values.
External expression validation in GSE36001
The GEO dataset GSE36001 was used exclusively as an independent expression validation cohort; because survival outcomes were unavailable, it was not used for prognostic validation11,27. The dataset included 19 osteosarcoma samples and six normal control samples. GPL6102 platform annotation was used to convert probe identifiers to gene symbols. When multiple probes mapped to the same gene, the probe with the highest average expression was retained. Differential expression between tumor and normal groups was assessed using limma28. Analyses were performed in R using limma (version 3.56.2), and adjusted P values were calculated using the Benjamini-Hochberg method.
qRT-PCR and Western blot validation
Experimental validation was performed using the human osteosarcoma cell line 143B and human osteoblast cells. Osteosarcoma cells were cultured in Dulbecco's modified Eagle's medium supplemented with 10% fetal bovine serum and 1% penicillin-streptomycin at 37 °C in a humidified atmosphere containing 5% CO₂, and passaged with 0.25% trypsin-EDTA at 80%–90% confluence. Human osteoblast cells were maintained under the recommended culture conditions. All cell lines were confirmed to be free of mycoplasma contamination. For qRT-PCR, total RNA was extracted using a phenol-guanidinium-based RNA extraction reagent, and RNA concentration and purity were assessed spectrophotometrically. One microgram of total RNA was reverse-transcribed using a reverse-transcription reagent according to the recommended protocol. qRT-PCR was performed using fluorescent DNA-binding dye-based chemistry under the following cycling conditions: initial denaturation at 95 °C for 30 s, followed by 40 cycles at 95 °C for 5 s and 60 °C for 30 s, with melt-curve analysis to confirm amplification specificity. Each reaction was performed in technical triplicate, and three independent biological experiments were conducted. GAPDH was used as the internal control, and relative PPARG expression was calculated using the 2-ΔΔCt method29. The PPARG forward primer was 5'-CGAAGACATTCCATTCACAAGAACAG-3', and the reverse primer was 5'-AGATGCAGGCTCCACTTTGATTG-3'.
Western blotting was performed to examine PPARG protein expression. Cells were lysed in radioimmunoprecipitation assay buffer supplemented with protease inhibitors, and protein concentrations were determined using a bicinchoninic acid assay. Equal amounts of protein (30 µg per lane) were separated by 10% sodium dodecyl sulfate-polyacrylamide gel electrophoresis and transferred onto polyvinylidene difluoride membranes. After blocking with 5% non-fat milk for 1 h at room temperature, membranes were incubated overnight at 4 °C with primary antibodies against PPARG (1:1,000) and GAPDH (1:5,000), followed by incubation with a horseradish peroxidase-conjugated secondary antibody (1:5,000) for 1 h at room temperature. Protein bands were visualized using chemiluminescence detection, and three independent experiments were performed. Band intensities were quantified using image-analysis software30. Between-group differences were analyzed using two-tailed unpaired Student's t tests. Data were presented as the mean ± standard deviation (SD) from three independent experiments, and P < 0.05 was considered statistically significant. Statistical analyses of experimental data were performed using statistical analysis software (version 9.0).
Statistical analysis
Unless otherwise specified, all bioinformatic analyses were performed in R (version 4.3.2). Two-sided P values < 0.05 were considered statistically significant. Correlations were assessed using Spearman's rank correlation coefficient (ρ). Multiple-testing correction was performed using the Benjamini-Hochberg FDR method where applicable. Experimental data were presented as the mean ± SD and were compared using two-tailed unpaired Student's t tests. Experimental statistical analyses were performed using statistical analysis software (version 9.0).