TP53 mutation-associated immune infiltration and a novel risk score model in HNSCC.

In HNSCC, few studies have focused on the relationship between wild-type TP53 and mutant TP53-related immunity and prognosis. Our objective was to explore how TP53 mutation regulates the immunophenotype of HNSCC and thus affects the prognosis of HNSCC. Cox and Lasso regression were used to establish a prognostic model of TP53-related immune genes, on which basis a nomogram was used to establish a clinical prediction model, and ROC curves were further used to evaluate the effectiveness of the model. The risk of death in the TP53WT group was only 0.68 times that in the TP53Mut group (HR = 0.68, CI: 0.5-0.91, P < 0.05). T cells, CD8 T cells, cytotoxic lymphocytes, B lineage, NK cells, myeloid dendritic cells, and fibroblasts were significantly different between the TP53Mut and TP53WT groups (all P < 0.05). Time - dependent ROC curves of nomogram were plotted for 1-, 3-, and 5-year survival to further verify the predictive power of the nomogram for prognosis, and the AUCs were 0.78, 0.82, and 0.83, respectively. We showed there are significant differences in the immune microenvironment associated with wild-type TP53 and mutant TP53. The immune model associated with TP53 mutation has a good prediction ability for the prognosis of HNSCC and may be of reference value for other tumors with high mutation rate of TP53. Notably, the effect of TP53 mutation on the prognosis of HNSCC could be illustrated from an immunologic perspective.