山东大学耳鼻喉眼学报 ›› 2026, Vol. 40 ›› Issue (2): 49-64.doi: 10.6040/j.issn.1673-3770.0.2025.048
刘佳珲,田汝宪,李玉梅,宋西成
LIU Jiahui, TIAN Ruxian, LI Yumei, SONG Xicheng
摘要: 目的 构建一个铜死亡相关长链非编码RNA(long non-coding ribonucleotide, lncRNA)模型,探讨其在预测头颈鳞状细胞癌(head and neck squamous cell carcinoma, HNSCC)患者预后中的价值,并通过药物敏感性分析初步探索HNSCC患者对多种化疗药物的敏感性。 方法 从癌症基因组图谱(the cancer genome atlas, TCGA)数据库下载HNSCC患者的转录组数据、肿瘤突变谱和临床信息,鉴定并筛选与预后有关的铜死亡相关lncRNA(cuproptosis-related lncRNA, CRL)并建立预后模型。根据风险评分将患者分为低危组和高危组,采用生存曲线、受试者工作特征(receiver operating characteristic, ROC)曲线、一致性指数和校准曲线评价预后模型的性能。Cox回归分析确定HNSCC的独立预后影响因素,建立预测列线图。功能富集分析与免疫浸润分析进一步探索预后模型的潜在分子机制和生物学基础。分析不同预后患者的肿瘤突变负荷(tumor mutational burden, TMB)及对化疗药物的敏感性。 结果 共鉴定出781个CRL,筛选得到9个预后相关的CRL被纳入预后模型的构建。生存曲线显示高危组患者与HNSCC不良预后相关(P<0.05)。在训练集中,预后模型预测1、3、5年生存率的ROC曲线下面积(Area Under the Curve, AUC)分别为0.694、0.753、0.643,且预后模型的一致性指数高于临床特征。年龄、肿瘤分期和风险评分是HNSCC的独立预后影响因素(P均<0.05)。功能富集分析显示,低危组和高危组之间的差异表达基因主要富集免疫相关蛋白和功能。免疫浸润分析显示,低危组患者8种免疫细胞表达水平和7个免疫功能评分较高。生存曲线显示,低TMB+低危组患者预后最好,高TMB+高危组患者预后最差(P<0.05)。药物敏感性分析显示,顺铂、依托泊苷、吉西他滨、丝裂霉素C、索拉非尼、长春瑞滨是治疗高危组患者的潜在药物,而雷帕霉素、苯乙双胍是低危组患者的潜在治疗药物。 结论 基于9个CRL构建的HNSCC患者预后预测模型可以较好预测HNSCC患者的预后,为进一步研究HNSCC治疗提供参考。
中图分类号:
| [1] Johnson DE, Burtness B, Leemans CR, et al. Head and neck squamous cell carcinoma[J]. Nat Rev Dis Primers, 2020, 6(1): 92. doi:10.1038/s41572-020-00224-3 [2] Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 74(3): 229-263. doi:10.3322/caac.21834 [3] Gormley M, Creaney G, Schache A, et al. Reviewing the epidemiology of head and neck cancer: definitions, trends and risk factors[J]. Br Dent J, 2022, 233(9): 780-786. doi:10.1038/s41415-022-5166-x [4] Ljungberg B, Bensalah K, Canfield S, et al. EAU guidelines on renal cell carcinoma: 2014 update[J]. Eur Urol, 2015, 67(5): 913-924. doi:10.1016/j.eururo.2015.01.005 [5] Jiang YC, Huo ZY, Qi XL, et al. Copper-induced tumor cell death mechanisms and antitumor theragnostic applications of copper complexes[J]. Nanomedicine, 2022, 17(5): 303-324. doi:10.2217/nnm-2021-0374 [6] Tang DL, Chen X, Kroemer G. Cuproptosis: a copper-triggered modality of mitochondrial cell death[J]. Cell Res, 2022, 32(5): 417-418. doi:10.1038/s41422-022-00653-7 [7] Wang YQ, Zhang L, Zhou FF. Cuproptosis: a new form of programmed cell death[J]. Cell Mol Immunol, 2022, 19(8): 867-868. doi:10.1038/s41423-022-00866-1 [8] Kahlson MA, Dixon SJ. Copper-induced cell death[J]. Science, 2022, 375(6586): 1231-1232. doi:10.1126/science.abo3959 [9] Jiang HY, Ma B, Xu WB, et al. A novel three-lncRNA signature predicts the overall survival of HNSCC patients[J]. Ann Surg Oncol, 2021, 28(6): 3396-3406. doi:10.1245/s10434-020-09210-1 [10] Chen Y, Luo TQ, Xu SS, et al. An immune-related seven-lncRNA signature for head and neck squamous cell carcinoma[J]. Cancer Med, 2021, 10(7): 2268-2285. doi:10.1002/cam4.3756 [11] Li QL, Wang J, Meng XY, et al. Identification of autophagy-related gene and lncRNA signatures in the prognosis of HNSCC[J]. Oral Dis, 2023, 29(1): 138-153. doi:10.1111/odi.13889 [12] Tsvetkov P, Coy S, Petrova B, et al. Copper induces cell death by targeting lipoylated TCA cycle proteins[J]. Science, 2022, 375(6586): 1254-1261. doi:10.1126/science.abf0529 [13] Zhou HY, Chen LH, Lei YJ, et al. Integrated analysis of tumor mutation burden and immune infiltrates in endometrial cancer[J]. Curr Probl Cancer, 2021, 45(2): 100660. doi:10.1016/j.currproblcancer.2020.100660 [14] Geeleher P, Cox N, Stephanie Huang R. pRRophetic: an R package for prediction of clinical chemotherapeutic response from tumor gene expression levels[J]. PLoS One, 2014, 9(9): e107468. doi:10.1371/journal.pone.0107468 [15] Minegishi Y, Coustan-Smith E, Rapalus L, et al. Mutations in Igalpha(CD79a)result in a complete block in B-cell development[J]. J Clin Invest, 1999, 104(8): 1115-1121. doi:10.1172/JCI7696 [16] Tkachenko A, Kupcova K, Havranek O. B-cell receptor signaling and beyond: the role of iGα(CD79a)/iGβ(CD79b)in normal and malignant B cells[J]. Int J Mol Sci, 2023, 25(1): 10. doi:10.3390/ijms25010010 [17] Wang YY, Xu Y, Hua QQ, et al. Novel prognostic model based on immune signature for head and neck squamous cell carcinoma[J]. Biomed Res Int, 2020, 2020: 4725314. doi:10.1155/2020/4725314 [18] Chow LQM. Head and neck cancer[J]. N Engl J Med, 2020, 382(1): 60-72. doi:10.1056/nejmra1715715 [19] Gong H, Liu ZL, Yuan CH, et al. Identification of cuproptosis-related lncRNAs with the significance in prognosis and immunotherapy of oral squamous cell carcinoma[J]. Comput Biol Med, 2024, 171: 108198. doi:10.1016/j.compbiomed.2024.108198 [20] Sun Q, Qin XM, Zhao J, et al. Cuproptosis-related LncRNA signatures as a prognostic model for head and neck squamous cell carcinoma[J]. Apoptosis, 2023, 28(1/2): 247-262. doi:10.1007/s10495-022-01790-5 [21] Zheng XW, Zheng DF, Zhang CM, et al. A cuproptosis-related lncRNA signature predicts the prognosis and immune cell status in head and neck squamous cell carcinoma[J]. Front Oncol, 2023, 13: 1055717. doi:10.3389/fonc.2023.1055717 [22] 姚天赐, 高鸿, 曹伟. 头颈部鳞状细胞癌铜死亡相关非编码长链RNA预后模型及药敏分析[J]. 中国临床药理学杂志, 2023, 39(22): 3331-3335. doi:10.13699/j.cnki.1001-6821.2023.22.029 YAO Tianci, GAO Hong, CAO Wei. Cuproptosis-long non-coding RNAs prognostic marker for head and neck squamous cell carcinoma and drug sensitivity analysis[J]. The Chinese Journal of Clinical Pharmacology, 2023, 39(22): 3331-3335. doi:10.13699/j.cnki.1001-6821.2023.22.029 [23] Li YQ. Copper homeostasis: Emerging target for cancer treatment[J]. IUBMB Life, 2020, 72(9): 1900-1908. doi:10.1002/iub.2341 [24] Zhu GC, Amin N, Herberg ME, et al. Association of tumor site with the prognosis and immunogenomic landscape of human papillomavirus-related head and neck and cervical cancers[J]. JAMA Otolaryngol Head Neck Surg, 2022, 148(1): 70-79. doi:10.1001/jamaoto.2021.3228 [25] 曹琳, 周梦娇, 丁一鸣, 等. GPR68和TIL对中晚期下咽鳞癌TPF诱导化疗疗效及预后的价值[J]. 中华耳鼻咽喉头颈外科杂志, 2022, 57(2): 178-184. doi:10.3760/cma.j.cn115330-20211218-00806 CAO Lin, ZHOU Mengjiao, DING Yiming, et al. Utility of GPR68 and TIL in TPF-induced chemotherapy and prognosis evaluation in middle-advanced hypopharyngeal squamous cell carcinoma[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2022, 57(2): 178-184. doi:10.3760/cma.j.cn115330-20211218-00806 [26] Shao F, Yang XY, Wang W, et al. Associations of PGK1 promoter hypomethylation and PGK1-mediated PDHK1 phosphorylation with cancer stage and prognosis: a TCGA pan-cancer analysis[J]. Cancer Commun, 2019, 39(1): 54. doi:10.1186/s40880-019-0401-9 [27] Bu WC, Cao MG, Wu XR, et al. Prognosis prediction of head and neck squamous cell carcinoma through the basement membrane-related lncRNA risk model[J]. Front Mol Biosci, 2024, 11: 1421335. doi:10.3389/fmolb.2024.1421335 [28] Ren JY, Yan BR, Wang XR, et al. A pyroptosis-related lncRNA risk model for the prediction of prognosis and immunotherapy response in head and neck squamous cell carcinoma[J]. Front Oncol, 2024, 14: 1478895. doi:10.3389/fonc.2024.1478895 [29] Chen Q, Shi X, Bao YY, et al. Deciphering disulfidptosis-linked lncRNA patterns as potential HNSCC biomarkers[J]. Oral Dis, 2025. doi:10.1111/odi.15283 [30] Kong JL, Sun WJ, Zhu WY, et al. Long noncoding RNA LINC01133 inhibits oral squamous cell carcinoma metastasis through a feedback regulation loop with GDF15[J]. J Surg Oncol, 2018, 118(8): 1326-1334. doi:10.1002/jso.25278 [31] Dreishpoon MB, Bick NR, Petrova B, et al. FDX1 regulates cellular protein lipoylation through direct binding to LIAS[J]. J Biol Chem, 2023, 299(9): 105046. doi:10.1016/j.jbc.2023.105046 [32] Han BA, Li S, Huang S, et al. Cuproptosis-related lncRNA SNHG16 as a biomarker for the diagnosis and prognosis of head and neck squamous cell carcinoma[J]. PeerJ, 2023, 11: e16197. doi:10.7717/peerj.16197 [33] Guo DF, Fan LW, Zeng HH, et al. Establishment and validation of a cuproptosis-related lncRNA signature that predicts prognosis and potential targeted therapy in hepatocellular carcinoma[J]. Biotechnol Genet Eng Rev, 2024, 40(2): 739-764. doi:10.1080/02648725.2023.2190640 [34] Zhang MZ, Xiao ZT, Xie YJ, et al. A cuproptosis-related lncRNA signature-based prognostic model featuring on metastasis and drug selection strategy for patients with lung adenocarcinoma[J]. Front Pharmacol, 2023, 14: 1236655. doi:10.3389/fphar.2023.1236655 [35] Liang S, Ji LT, Yu ZY, et al. Bioinformatic analysis and experimental validation of cuproptosis-related LncRNA as a novel biomarker for prognosis and immunotherapy of oral squamous cell carcinoma[J]. Hereditas, 2024, 161(1): 10. doi:10.1186/s41065-024-00311-5 [36] Zhou LQ, Cheng Q, Hu Y, et al. Cuproptosis-related LncRNAs are potential prognostic and immune response markers for patients with HNSCC via the integration of bioinformatics analysis and experimental validation[J]. Front Oncol, 2022, 12: 1030802. doi:10.3389/fonc.2022.1030802 [37] Liu XJ, Cheng WW, Li HQ, et al. Identification and validation of cuproptosis-related LncRNA signatures as a novel prognostic model for head and neck squamous cell cancer[J]. Cancer Cell Int, 2022, 22(1): 345. doi:10.1186/s12935-022-02762-0 [38] Yang LQ, Yu JL, Tao L, et al. Cuproptosis-related lncRNAs are biomarkers of prognosis and immune microenvironment in head and neck squamous cell carcinoma[J]. Front Genet, 2022, 13: 947551. doi:10.3389/fgene.2022.947551 [39] Li YJ, Li HY, Zhang Q, et al. The prognostic value and immune landscape of a cuproptosis-related lncRNA signature in head and neck squamous cell carcinoma[J]. Front Genet, 2022, 13: 942785. doi:10.3389/fgene.2022.942785 [40] Zhao Z, Li YL, Wu YQ, et al. Deep learning-based model for predicting progression in patients with head and neck squamous cell carcinoma[J]. Cancer Biomark, 2020, 27(1): 19-28. doi:10.3233/CBM-190380 [41] Burger JA, Wiestner A. Targeting B cell receptor signalling in cancer: preclinical and clinical advances[J]. Nat Rev Cancer, 2018, 18(3): 148-167. doi:10.1038/nrc.2017.121 [42] Schreibelt G, Bol KF, Aarntzen EH, et al. Importance of helper T-cell activation in dendritic cell-based anticancer immunotherapy[J]. Oncoimmunology, 2013, 2(6): e24440. doi:10.4161/onci.24440 [43] Cho Y, Miyamoto M, Kato K, et al. CD4+ and CD8+ T cells cooperate to improve prognosis of patients with esophageal squamous cell carcinoma[J]. Cancer Res, 2003, 63(7): 1555-1559. [44] Kim SS, Shen S, Miyauchi S, et al. B cells improve overall survival in HPV-associated squamous cell carcinomas and are activated by radiation and PD-1 blockade[J]. Clin Cancer Res, 2020, 26(13): 3345-3359. doi:10.1158/1078-0432.CCR-19-3211 [45] Attramadal CG, Kumar S, Gao J, et al. Low mast cell density predicts poor prognosis in oral squamous cell carcinoma and reduces survival in head and neck squamous cell carcinoma[J]. Anticancer Res, 2016, 36(10): 5499-5506. doi:10.21873/anticanres.11131 [46] Rodrigo JP, Sánchez-Canteli M, López F, et al. Tumor-infiltrating lymphocytes in the tumor microenvironment of laryngeal squamous cell carcinoma: systematic review and meta-analysis[J]. Biomedicines, 2021, 9(5): 486. doi:10.3390/biomedicines9050486 [47] Farah CS. Molecular landscape of head and neck cancer and implications for therapy[J]. Ann Transl Med, 2021, 9(10): 915. doi:10.21037/atm-20-6264 [48] Nathan CA, Khandelwal AR, Wolf GT, et al. TP53 mutations in head and neck cancer[J]. Mol Carcinog, 2022, 61(4): 385-391. doi:10.1002/mc.23385 [49] Chen ZG, Saba NF, Teng Y. The diverse functions of FAT1 in cancer progression: good, bad, or ugly?[J]. J Exp Clin Cancer Res, 2022, 41(1): 248. doi:10.1186/s13046-022-02461-8 [50] Cao HT, Lan TJ, Kuang SJ, et al. FAT1 as a tumor mutation burden specific gene affects the immunotherapy effect in head and neck squamous cell cancer[J]. Drug Resist Updat, 2024, 76: 101095. doi:10.1016/j.drup.2024.101095 [51] Kitamura N, Sento S, Yoshizawa Y, et al. Current trends and future prospects of molecular targeted therapy in head and neck squamous cell carcinoma[J]. Int J Mol Sci, 2020, 22(1): 240. doi:10.3390/ijms22010240 [52] Guigay J, Aupérin A, Fayette J, et al. Cetuximab, docetaxel, and cisplatin versus platinum, fluorouracil, and cetuximab as first-line treatment in patients with recurrent or metastatic head and neck squamous-cell carcinoma(GORTEC 2014-01 TPExtreme): a multicentre, open-label, randomised, phase 2 trial[J]. Lancet Oncol, 2021, 22(4): 463-475. doi:10.1016/S1470-2045(20)30755-5 [53] Tao YG, Bardet E, Rosine D, et al. Phase I trial of oral etoposide in combination with radiotherapy in head and neck squamous cell carcinoma-GORTEC 2004-02[J]. Radiat Oncol, 2013, 8: 40. doi:10.1186/1748-717X-8-40 [54] Vanderveken OM, Szturz P, Specenier P, et al. Gemcitabine-based chemoradiation in the treatment of locally advanced head and neck cancer: systematic review of literature and meta-analysis[J]. Oncologist, 2016, 21(1): 59-71. doi:10.1634/theoncologist.2015-0246 [55] Haffty BG, Son YH, Sasaki CT, et al. Mitomycin C as an adjunct to postoperative radiation therapy in squamous cell carcinoma of the head and neck: results from two randomized clinical trials[J]. Int J Radiat Oncol Biol Phys, 1993, 27(2): 241-250. doi:10.1016/0360-3016(93)90234-m [56] Affolter A, Samosny G, Heimes AS, et al. Multikinase inhibitors sorafenib and sunitinib as radiosensitizers in head and neck cancer cell lines[J]. Head Neck, 2017, 39(4): 623-632. doi:10.1002/hed.24557 [57] Erjala K, Pulkkinen J, Kulmala J, et al. Concomitant vinorelbine and radiation in head and neck squamous cell carcinoma in vitro[J]. Acta Oncol, 2004, 43(2): 169-174. doi:10.1080/02841860310023110 [58] Ren GX, Hu JZ, Wang RX, et al. Rapamycin inhibits Toll-like receptor 4-induced pro-oncogenic function in head and neck squamous cell carcinoma[J]. Oncol Rep, 2014, 31(6): 2804-2810. doi:10.3892/or.2014.3134 [59] Shen YQ, Guerra-Librero A, Fernandez-Gil BI, et al. Combination of melatonin and rapamycin for head and neck cancer therapy: suppression of AKT/mTOR pathway activation, and activation of mitophagy and apoptosis via mitochondrial function regulation[J]. J Pineal Res, 2018, 64(3). doi:10.1111/jpi.12461.doi:10.1111/jpi.12461 [60] Day TA, Shirai K, O'Brien PE, et al. Inhibition of mTOR signaling and clinical activity of rapamycin in head and neck cancer in a window of opportunity trial[J]. Clin Cancer Res, 2019, 25(4): 1156-1164. doi:10.1158/1078-0432.CCR-18-2024 [61] Seo YS, Kim TH, Lim H, et al. Phenformin induces caspase-dependent apoptosis of FaDu head and neck squamous cell carcinoma cells[J]. Anticancer Res, 2019, 39(7): 3499-3506. doi:10.21873/anticanres.13496 [62] Zhuang DX, Wang SS, Deng HT, et al. Phenformin activates ER stress to promote autophagic cell death via NIBAN1 and DDIT4 in oral squamous cell carcinoma independent of AMPK[J]. Int J Oral Sci, 2024, 16(1): 35. doi:10.1038/s41368-024-00297-w |
| [1] | 盘琳琳,万佳明,李越,何龙. 自噬相关LncRNA是头颈部鳞状细胞癌的预后指标[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 97-107. |
| [2] | 吴敏,李正阳,孟杰,叶惠平. 程序性细胞死亡的分子机制和其在鼻咽癌中的作用[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 152-157. |
| [3] | 张茂华,魏日富,朱忠寿,刘平,高尚,李慧凤. LncRNA PCAT-1对鼻咽癌细胞生物学行为及化疗敏感性的影响[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 68-76. |
| [4] | 杨煜雲,黄艳利,李军政. 铜配合物在抗肿瘤治疗中的研究进展[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 145-152. |
| [5] | 宋斐,宋昊,李玉梅,牟亚魁,宋西成. 肿瘤源性外泌体在头颈鳞状细胞癌微环境中的免疫调节作用[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 92-100. |
| [6] | 张永红,张辉,王彩华,杨欣欣,吴允刚,赵玉凤,庞太忠,李晓瑜. 基于TCGA数据库构建喉鳞状细胞癌免疫相关基因预后模型及筛选靶向分子药物[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 54-62. |
| [7] | 黄艳利,李军政. 铜诱导肿瘤细胞死亡机制及其在肿瘤治疗中的研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 198-205. |
|