Notably, 18 of the 20 downregulated DE-TrpGs (ALDH9A1, ALDH3A2, ADH1B, AOX1, MAOA, ECHS1, ALDH2, ACAT1, HAAO, ALDH7A1, HADHA, AKR1A1, CYP4X1, INMT, CYP2U1, CAT, HADH, and NMNAT1) showed significantly reduced expression specifically in ESCC fibroblasts compared to their normal counterparts. Here, ACAT1 is linked to esophageal squamous cell carcinoma.