Research Paper Volume 12, Issue 20 pp 20778—20800

Identification of a nomogram based on an 8-lncRNA signature as a novel diagnostic biomarker for head and neck squamous cell carcinoma

Rui Mao1, *, , Yuanyuan Chen2, *, , Lei Xiong3, *, , Yanjun Liu1,4, , Tongtong Zhang5, ,

  • 1 Affiliated Hospital of Southwest Jiaotong University, Chengdu 610036, China
  • 2 Department of Pathology, The Third People’s Hospital of Chengdu, Chengdu 610031, China
  • 3 Department of Otolaryngology, The Third People’s Hospital of Chengdu, Chengdu 610031, China
  • 4 The Center of Gastrointestinal and Minimally Invasive Surgery, The Third People’s Hospital of Chengdu, Chengdu 610031, China
  • 5 Medical Research Center, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, The Second Chengdu Hospital Affiliated to Chongqing Medical University, Chengdu 610031, Sichuan, China
* Equal contribution

Received: April 14, 2020       Accepted: August 17, 2020       Published: October 22, 2020
How to Cite

Copyright: © 2020 Mao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Long noncoding RNAs (lncRNAs) have been proposed as diagnostic or prognostic biomarkers of head and neck squamous carcinoma (HNSCC). The current study aimed to develop a lncRNA-based prognostic nomogram for HNSCC. LncRNA expression profiles were downloaded from The Cancer Genome Atlas (TCGA) database. After the reannotation of lncRNAs, the differential analysis identified 253 significantly differentially expressed lncRNAs in training set TCGA-HNSC (n = 300). The prognostic value of each lncRNA was first estimated in univariate Cox analysis, and 41 lncRNAs with P < 0.05 were selected as seed lncRNAs for Cox LASSO regression, which identified 11 lncRNAs. Multivariate Cox analysis was used to establish an 8-lncRNA signature with prognostic value. Patients in the high-signature score group exhibited a significantly worse overall survival (OS) than those in the low-signature score group, and the area under the receiver operating characteristic (ROC) curve for 3-year survival was 0.74. Multivariable Cox regression analysis among the clinical characteristics and signature scores suggested that the signature is an independent prognostic factor. The internal validation cohort, external validation cohort, and 102 HNSCC specimens quantified by qRT-PCR successfully validate the robustness of our nomogram.


HNSCC: head and neck squamous carcinoma; TCGA: The Cancer Genome Atlas; GEO: Gene Expression Omnibus; lncRNAs: Long noncoding RNAs; ROC: receiver operating characteristic; OS: overall survival; AUC: the area under the curve; WGCNA: weighted gene coexpression network; LASSO: least absolute shrinkage and selection operator; KEGG: Kyoto Encyclopedia of Genes and Genomes; qRT-PCR: Real-time quantitative reverse transcription polymerase chain reaction.