Weighted gene co-expression network analysis (WGCNA) analysis, applied to 639 PCa samples and 537 ac4C-associated different expression genes (DEGs), grouped these genes into a 12-gene module, with β = 5 as the optimal soft threshold (Fig. 6d-e).To investigate clinical relevance, the MEBlack module genes were analyzed for correlations with NAT10 expression, immune microenvironment scores, and clinical factors such as Gleason score, T-stage, and biochemical recurrence (p < 0.05) (Fig. 6f). This evidence concerns the gene NAT10 and posterior cortical atrophy.