Abstract

BackgroundOral squamous cell carcinoma (OSCC) is one of the most common maligancies of the head and neck. The prognosis was is significantly different among OSCC patients. This study aims to identify new biomarkers to establish a prognostic model to predict the survival of OSCC patients.MethodsThe mRNA expression and corresponding clinical information of OSCC patients were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus. Additionally, a total of 26 hypoxia-related genes were also obtained from a previous study. Univariate Cox regression analysis and LASSO Cox regression analysis were performed to screen the optimal hypoxia-related genes which were associated with the prognosis of OSCC. to establish the predictive model (Risk Score) was established for estimating the patient's overall survival (OS). Multivariate Cox regression analysis was used to determine whether the Risk Score was an independent prognostic factor. Based on all the independent prognostic factors, nomogram was established to predict the OS probability of OSCC patients. The relative proportion of 22 immune cell types in each patient was evaluated by CIBERSORT software.ResultsWe determined that a total of four hypoxia-related genes including ALDOA, P4HA1, PGK1 and VEGFA were significantly associated with the prognosis of OSCC patients. The nomogram established based on all the independent factors could reliably predict the long-term OS of OSCC patients. In addition, our resluts indicated that the inferior prognosis of OSCC patients with high Risk Score might be related to the immunosuppressive microenvironments.ConclusionThis study shows that high expression of hypoxia-related genes including ALDOA, P4HA1, PGK1 and VEGFA is associated with poor prognosis in OSCC patients, and they can be used as potential markers for predicting prognosis in OSCC patients.

Highlights

  • Oral squamous cell carcinoma (OSCC) is one of the most universal tumors in the head and neck, with the global incidence rate is the eighth of all cancers [1]

  • LASSO Cox regression analysis Basing on the mRNA expression values of 26 hypoxiarelated genes, the univariate Cox regression analysis was conducted, and the genes significantly related to the prognosis of OSCC were selected with P < 0.05 as the threshold

  • Hypoxia‐related genes could separate prognostically different OSCC patients The factoextra function package in R language was used for clustering analysis for OSCC patients in TCGA based on the expression values of 26 hypoxiarelated genes

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Summary

Introduction

Oral squamous cell carcinoma (OSCC) is one of the most universal tumors in the head and neck, with the global incidence rate is the eighth of all cancers [1]. Zhao et al BMC Oral Health (2021) 21:232 supply and accelerated tumor metabolism leading to increased oxygen consumption. Hypoxia can change the abundance of gene expression, which will result in proteomics changes and affect cell physiological and biochemical functions [7]. Hypoxia affects the sensitivity of tumor cells to chemotherapy and radiotherapy, and its presence has a significant negative impact on the prognosis of patients after radiotherapy [10]. Oral squamous cell carcinoma (OSCC) is one of the most common maligancies of the head and neck. This study aims to identify new biomarkers to establish a prognostic model to predict the survival of OSCC patients

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