We identified 7 prognostic genes related to macrophage polarization and mitochondria in PRAD (ABHD11, PTRH2, CAT, NTHL1, SLC25A39, OXR1, and GSTZ1), through a series of bioinformatics methods, and explored the independent prognostic factors, immune defense mechanisms, and chemotherapeutic drug sensitivity of PRAD, providing a new theoretical basis for exploring the immune defense mechanisms and targeted therapeutic drugs in PRAD. This evidence concerns the gene PTRH2 and prostate adenocarcinoma.