Identification of key survival genes of the tumor microenvironment and immune infiltration in head and neck squamous cell carcinoma

Abstract

\n Background: Head and neck cancer (HNC) are highly aggressive solid tumors with poor prognoses. The tumor microenvironment (TME) plays a critical role in angiogenesis, invasion, and metastasis of HNC. In the TME, immune and stromal cells influence tumor initiation, response, and therapy. Our study aimed to evaluate the progression and prognosis of HNC by analyzing the key genes involved in immunization and stromal cells. Methods: Gene expression profiles, demographics, and survival data were downloaded from the TCGA database. Patients with HNC were divided into high immune/stromal score groupss or low immune/stromal score groups based on the ESTIMATE algorithm. Differentially expressed genes (DEGs) were identified via functional enrichment analysis and protein-protein interaction networks, and survival analysis based on DEGs was also performed.Results: A total of 522 patients with HNC were enrolled for analysis. The average age was 60.87, and one-third of the patients were HPV-positive. Kaplan-Meier survival analysis showed that patients median survival time in the low-score group was shorter than that of the high-score group (625 vs. 680 days, log-rank, p = 0.1716). According to immune scores, 925 genes were upregulated, and 72 genes were downregulated in the high-score group compared with the low-score group. Top Gene Ontology terms identified that T-cell costimulation, regulation of immune response, and the external side of the plasma membrane were the most involved pathways. Moreover, Kaplan-Meier analysis revealed that 480 DEGs were upregulated in the high-immune scores group, and a total of 126 DEGs were significantly associated with poor survival. Besides, we identified the hub genes of DEGs through protein-protein interactions and found that PTPRC, CD247, and CD4 are associated with immune infiltration and all-cause mortality.Conclusions: We identified a series of TME‐related genes significantly associated with overall mortality; this information is crucial for further understanding the role of TME and immune infiltration in the prognosis of HNC.