Introduction. The incidence of liver cancer is increasing globally. Fatty acids in lipid metabolism are associated with cancer risk by maintaining cancer cell membrane structure and transducing cancer signaling, and their increased synthesis promotes tumor growth, angiogenesis, and tumor metastasis. Methods. After identification of the ELOVL3 gene involved in fatty acid metabolism, which is related to the prognosis of liver cancer, its expression level was extracted from The Cancer Genome Atlas (TCGA) database, and differential analysis, survival analysis, clinical correlation analysis and nomogram were used to predict the survival rate. A comprehensive meta-analysis was performed to further evaluate the prognostic value of ELOVL3. Finally, enrichment analysis and immune analysis were performed on the high and low expression groups of ELOVL3 gene to explore the value of ELOVL3 in predicting the prognosis and immunotherapy of liver cancer patients. Results. Patients with high ELOVL3 expression had poor overall survival and progression-free survival. The nomogram and the area under the ROC curve also indicated that the expression of ELOVL3 gene had high accuracy in predicting the survival time of liver cancer patients. The expression of ELOVL3 was significantly different in the early stage of tumor grade, tumor stage and T stage. Enrichment analysis and immunological analysis revealed a variety of information. The immunotherapy analysis also showed that low ELOVL3 was more effective than high ELOVL3 when receiving immunotherapy. Conclusion. The expression of ELOVL3 gene is significantly elevated in HCC and is associated with cancer development and poor prognosis.
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