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Peer-reviewedCC BY 4.0PeerJ

Prediction of prognosis and treatment effect of cervical cancer by immunogenic cell death-related genes

  1. 1Department of Gynecology, Jiaozhou Hospital Affiliated to Dongfang Hospital of Tongji University, Qingdao, Shandong Province, China
  2. 2Health Care Department, Qingdao Municipal Hospital, Qingdao, Shandong Province, China
  3. 3Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China

Abstract

Background: Immunogenic cell death (ICD) is a potential mechanism that mediates adaptive immune responses during anticancer therapy. However, expression patterns and clinical implications of ICD related genes in cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) remain unclear. This study aimed to investigate the associations of 34 ICD related genes with immune characteristics, prognosis, and immune checkpoint blocking (ICB) efficacy in CESC and to predict drug responses across different risk subgroups.

Methods: Ribonucleic acid sequencing (RNA-seq) transcriptomic profiles, standard normalized variate (SNV) data, and corresponding clinicopathological information were retrieved from The Cancer Genome Atlas (TCGA). Consensus clustering was applied to identify two ICD related molecular subtypes. A prognostic signature was constructed using least absolute shrinkage and selection operator (LASSO) Cox regression and validated using immunohistochemistry (IHC) and receiver operating characteristic (ROC) curve analyses. Immunotherapy responses were predicted based on the risk score of the established model.

Results: The ICD-high subtype (C2) was associated with favorable clinical outcomes and enhanced immune activation. The prognostic signature comprised six genes: ATG5, FOXP3, IFNG, IL1B, PDIA3, and TNF. IHC confirmed higher expression of ATG5 and PDIA3 in cervical cancer (CC) tissues than in normal cervical tissues, and ROC curves verified the predictive accuracy. Furthermore, immunophenoscore (IPS) and tumor immune dysfunction and exclusion (TIDE) scores suggested that low risk patients exhibited better responses to anti programmed cell death protein-1 (PD-1) immunotherapy.

Conclusions: This study characterized the expression profiles of ICD related genes and established a novel ICD based classification system for CESC. Comprehensive analyses of the tumor immune microenvironment further validated the capacity of this signature in predicting prognosis and immunotherapy benefits, which may help identify CC patients who are most likely to benefit from immunotherapy.

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BibTeX
@article{li2026prediction,
  title = {{Prediction of prognosis and treatment effect of cervical cancer by immunogenic cell death-related genes}},
  author = {Xiufang Li and Xiaona Luan and Yewu Sun and Liying Huang and Yan Kong and Tian Tian},
  journal = {PeerJ},
  year = {2026},
  month = oct,
  doi = {10.7717/peerj.21635},
  url = {https://peerj.com/articles/21635},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Prediction of prognosis and treatment effect of cervical cancer by immunogenic cell death-related genes
AU  - Xiufang Li
AU  - Xiaona Luan
AU  - Yewu Sun
AU  - Liying Huang
AU  - Yan Kong
AU  - Tian Tian
PY  - 2026
DA  - 2026/10/07
JO  - PeerJ
DO  - 10.7717/peerj.21635
UR  - https://peerj.com/articles/21635
AB  - Background: Immunogenic cell death (ICD) is a potential mechanism that mediates adaptive immune responses during anticancer therapy. However, expression patterns and clinical implications of ICD related genes in cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) remain unclear. This study aimed to investigate the associations of 34 ICD related genes with immune characteristics, prognosis, and immune checkpoint blocking (ICB) efficacy in CESC and to predict drug responses across different risk subgroups.  Methods: Ribonucleic acid sequencing (RNA-seq) transcriptomic profiles, standard normalized variate (SNV) data, and corresponding clinicopathological information were retrieved from The Cancer Genome Atlas (TCGA). Consensus clustering was applied to identify two ICD related molecular subtypes. A prognostic signature was constructed using least absolute shrinkage and selection operator (LASSO) Cox regression and validated using immunohistochemistry (IHC) and receiver operating characteristic (ROC) curve analyses. Immunotherapy responses were predicted based on the risk score of the established model.  Results: The ICD-high subtype (C2) was associated with favorable clinical outcomes and enhanced immune activation. The prognostic signature comprised six genes: ATG5, FOXP3, IFNG, IL1B, PDIA3, and TNF. IHC confirmed higher expression of ATG5 and PDIA3 in cervical cancer (CC) tissues than in normal cervical tissues, and ROC curves verified the predictive accuracy. Furthermore, immunophenoscore (IPS) and tumor immune dysfunction and exclusion (TIDE) scores suggested that low risk patients exhibited better responses to anti programmed cell death protein-1 (PD-1) immunotherapy.  Conclusions: This study characterized the expression profiles of ICD related genes and established a novel ICD based classification system for CESC. Comprehensive analyses of the tumor immune microenvironment further validated the capacity of this signature in predicting prognosis and immunotherapy benefits, which may help identify CC patients who are most likely to benefit from immunotherapy.
SN  - 2167-8359
ER  -