A six-mRNA prognostic model to predict survival in head and neck squamous cell carcinoma

Figures & data

Figure 1 Flow diagram of the analysis procedure: data collection, preprocessing, analysis, and validation.

Abbreviations: DEGs, differentially expressed genes; ROC, receiver operating characteristic; TCGA, The Cancer Genome Atlas.

Figure 2 Identification of modules associated with the clinical traits of HNSCC.

Notes: (A) Distribution of average GS and errors in the modules associated with progression of HNSCC. (B) Heatmap of the correlation between MEs and clinical traits of HNSCC.

Abbreviations: GS, gene significance; HNSCC, head and neck squamous cell carcinoma; ME, module eigengene.

Figure 3 The risk score performance in the training data sets.

Notes: (A-F) The survival plot and the 5-year survival ROC curve of OS, DSS, and PFS. (G–I) The relationship between risk score, survival information, and z-score transformed expression values are shown (top-down, FOXL2NB, PCOLCE2, SPINK6, ULBP2, KCNJ18, and RFPL1).

Abbreviations: AUC, area under the curve; DSS, disease-specific survival; OS, overall survival; PFS, progression-free survival; ROC, receiving operating characteristic.

Table 1 Association of the six-mRNA signature with clinicopathological characteristics in HNSCC patients (n=477)

Variables	Six-mRNA signature		P-value
	Low riska	High riska
Alcohol			0.020
Yes	103	216
No	65	83
Smoke			0.089
Yes	82	122
No	88	185
Smoked packs			0.355
<40 packs	34	84
≥40 packs	54	101
pTNM stage			0.010
Stage I	15	10
Stage II	29	36
Stage III	28	47
Stage IV	76	171
HPV status			0.765
Positive	7	7
Negative	26	37
Grade			0.000
G1	36	25
G2	102	194
G3	32	86
G4	0	2
Age (years)			0.315
≥60	103	170
<60	67	137
Sex			0.105
Male	116	232
Female	54	75
Radiotherapy			0.007
Yes	31	81
No	29	29

Notes:

a Low risk refers to ≤ cutoff value of risk score, high risk refers to > cutoff value of risk score; the chi-squared test; P-value <0.05 was considered significant.

Abbreviations: HNSCC, head and neck squamous cell carcinoma; HPV, human papillomavirus; pTNM, pathological tumor-node-metastasis..

Table 2 Univariable and multivariable Cox regression analyses of the six-mRNA signature and survival of HNSCC patients in the training, test, and entire group

Variables		The training set (n=287)					The test set (n=190)
		HR	95% CI of HR			P-value	HR	95% CI of HR		P-value
			Lower	Upper				Lower	Upper
Univariate analysis
Sex	Male vs women	1.205	0.820	1.771		0.343	1.413	0.907	2.256	0.124
Age (years)	≥60 vs <60	1.165	0.807	1.683		0.414	1.711	1.096	2.671	0.018
Grade	G1/G2–G4	0.6868	0.4034	1.169		0.1664	0.485	0.211	1.119	0.09
Smoke	Yes/no	1.076	0.748	1.548		0.693	1.026	0.660	1.597	0.909
Alcohol	Yes/no	1.296	0.879	1.911		0.191	0.647	0.411	1.019	0.060
pTNM	I, II/III, IV	2.564	1.439	4.567		0.0014	1.503	0.828	2.728	0.181
Risk	High vs low	3.314	2.135	5.145		0.000	2.140	1.276	3.591	0.004
Multivariable analysis
Sex	Man vs woman	0.699	0.454	1.078	0.105		0.729	0.448	1.183	0.201
Age (years)	≥60 vs <60	1.428	0.961	2.124	0.078		1.488	0.926	2.392	0.100
Grade	G1/G2–G4	0.857	0.488	1.506	0.592		0.689	0.289	1.641	0.401
Smoke	Yes/no	0.982	0.667	1.447	0.928		1.069	0.676	1.689	0.775
Alcohol	Yes/no	1.391	0.907	2.133	0.130		0.606	0.372	0.987	0.044
pTNM	I, II/III, IV	2.040	1.136	3.661	0.017		1.449	0.779	2.694	0.242
Risk	High vs low	3.302	2.080	5.242	0.000		2.338	1.361	4.015	0.002

Abbreviations: HNSCC, head and neck squamous cell carcinoma; pTNM, pathological tumor-node-metastasis.

Figure 4 GSEA performed identify the potential pathways that differentiate the high-/low-risk groups.

Note: The graphs depict only the six common functional gene sets enriched in HNSCC samples.

Abbreviations: GSEA, gene set enrichment analysis; HNSCC, head and neck squamous cell carcinoma.