PAMcluster-B, which had a moderate survival probability, was significantly higher expressed in cancer-related pathway including NRF-2, RTK/RAS, TGF-β compared A and C. Activation of these signaling pathways and increased levels of immunosuppressive cell infiltration both predicted poor prognosis and rapid progression of cancer, confirming an essential association and possible mechanisms of polyamine metabolism in cancer signal pathway and TME remodeling. Here, TGFB1 is linked to cancer.