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Background: The risk factors for the survival of elderly patients with oral squamous cell carcinoma (OSCC) are multifarious. Here, we developed a novel clinical signature to serve as an indicator of prognosis in these patients. Materials and methods: Clinicopathological data were collected for 554 patients aged ≥ 60 years who were treated for primary OSCC. Overall survival (OS), disease-specific survival, and disease-free survival were the primary outcomes. Results: Multivariate cox regression analysis showed that high N stage, low hemoglobin level, low body mass index (BMI), and high neutrophil-to-lymphocyte ratio (NLR) showed a poor survival (P < 0.05). A nomogram was constructed with a c-index of 0.702. Conclusion: A novel clinical signature including hemoglobin level, BMI, and NLR, which are obtained through noninvasive examinations can be used as prognostic indicators in clinical practice for elderly patients with OSCC. [ABSTRACT FROM AUTHOR]

Objective: Tongue and mouth floor squamous cell carcinoma (T/MF SCC) exhibits a high rate of local recurrence and cervical lymph node metastasis. The effect of the tumor microenvironment on T/MF SCC remains unclear.Materials and Methods: Transcriptome and somatic mutation data of patients with T/MF SCC were obtained from HNSC projects of the Cancer Genome Atlas. Immune infiltration quantification in early- (clinical stage I-II) and advanced-stage (clinical stage III-IV) T/MF SCC was performed using single sample Gene Set Enrichment Analysis and MCPcounter. Differentially expressed gene data were filtered, and their function was assessed through Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses. Kaplan-Meier survival curve analysis and Cox regression model were conducted to evaluate the survival of patients with the CCL22 signature. Maftools was used to present the overview of somatic mutations.Results: In T/MF SCC, T helper (Th)2 cell counts were significantly increased in patients with early-stage disease compared to those with advanced-stage disease. Expression of the Th2 cell-related chemokine, CCL22, was downregulated in patients with advanced-stage T/MF SCC. Univariate and multivariate Cox analyses revealed that CCL22 was a good prognostic factor in T/MF SCC. A nomogram based on the expression of CCL22 was constructed to serve as a prognostic indicator for T/MF SCC. NOTCH1 mutations were found at a higher rate in patients with advanced-stage T/MF SCC than in those with early-stage T/MF SCC, resulting in the inhibition of the activation of the NOTCH1-Th2 cell differentiation pathway. The expression levels of CCL22, GATA-3, and IL4 were higher in patients with early-stage T/MF SCC than in those with advanced-stage T/MF SCC.Conclusion: In T/MF SCC, high expression of CCL22 may promote the recruitment of Th2 cells and help predict a better survival. Mutations in NOTCH1 inhibit the differentiation of Th2 cells, facilitating tumor progression through a decrease in Th2 cell recruitment and differentiation. [ABSTRACT FROM AUTHOR]