An immune related cell death index for prognostic stratification and immunotherapy response prediction in oral cancer.

Immune-related cell death (IRCD) plays a crucial role in the immune microenvironment, development, and deterioration of oral cancer. However, reliable immune-related cell death profiles have not been explored. In this study, based on multiple oral cancer datasets such as TCGA, tumors were divided into two immune subtypes, "Hot" and "Cold", using the ConsensusClusterPlus algorithm, and significant differences were found between the two in immune cell infiltration, microenvironment activity, and immunotherapy responsiveness. The immune-related cell death index (IRCDI) based on immune-related cell death gene (IRCDG) was further constructed to reveal that IRCDI can be used as an independent prognostic indicator and is closely related to immune activity, gene mutation characteristics and a variety of signaling pathways. Both single cell analysis and immunosubtype analysis showed that low IRCDI was closely related to enhanced immunocompetence. Although IRCDI has a limited predictive role in the TIDE algorithm, it has a good predictive ability in multiple real immunotherapy cohorts and shows specific sensitivity to different drugs, suggesting that IRCDI is expected to be an important biomarker to guide individualized treatment of oral cancer.