Identification and Validation of a Four-Gene Prognostic Signature Based on PPAR Signaling Pathway for Oral Squamous Cell Carcinoma

Abstract

Abstract This study aims to create a novel prognosis-related risk signature for oral squamous cell carcinoma (OSCC) based on the PPAR signaling pathway. TCGA and GEO data were respectively evaluated and verified. For the purpose of identifying OSCC prognostic genes, LASSO regression, univariate Cox, and multivariate Cox analyses were conducted. The predictive characteristic of OSCC was determined to be a combination of four genes (ACAA1, PCK1, APOA2, and OLR1) that were involved in the PPAR signaling pathway. On the basis of the multivariate Cox regression coefficients, the risk score was established, which was equal to (-0.378×ACAA1 value)+(1.023×PCK1 value)+(0.301×APOA2 value)+(0.142×OLR1 value). Kaplan-Meier survival analysis demonstrated that risk score had strong prognostic capability in both TCGA dataset and GEO dataset. Moreover, we constructed a nomogram utilizing clinical factors and risk score to estimate the likelihood of OSCC patient survival. In addition, the patterns of cellular immune infiltration in the tumor samples varied considerably between groups with different risk scores. In conclusion, the four-gene signature could accurately and independently predict OSCC prognosis. These genes may possibly be therapeutic targets for OSCC and bring new insights into the prognosis of OSCC.