# Construction of a nomogram for predicting HNSCC distant metastasis and identification of EIF5A as a hub gene

## TL;DR

This study develops a predictive model and identifies a key gene, EIF5A, for early detection of distant metastasis in head and neck cancer.

## Contribution

A nomogram for predicting HNSCC distant metastasis and EIF5A as a hub gene are introduced for early diagnosis and mechanism study.

## Key findings

- A nomogram based on 23 lncRNAs was developed to predict distant metastasis in HNSCC patients.
- EIF5A was identified as the gene most closely related to HNSCC distant metastasis through WGCNA and Cytoscape analysis.
- High EIF5A expression was confirmed in primary tumor tissues of HNSCC patients with distant metastasis via immunohistochemistry.

## Abstract

Patients with distant metastasis of head and neck squamous cell carcinoma (HNSCC) often have a poor prognosis. However, early diagnosis of distant metastasis is challenging in clinical practice, and distant metastasis is often only detected in the late stages of tumor metastasis through imaging techniques. In this study, we utilized data from HNSCC patients collected from the TCGA database. Patients were divided into distant metastasis and nonmetastasis groups based on the tumor–node–metastasis (TNM) stage. We analyzed the differentially expressed genes between the two groups (DM/non-M DEGs) and their associated lncRNAs and generated a predictive model based on 23 lncRNAs that were significantly associated with the occurrence of distant metastasis in HNSCC patients. On this basis, we built a nomogram to predict the distant metastasis of HNSCC patients. Moreover, through WGCNA and Cytoscape software analysis of DM/non-M DEGs, we identified the gene most closely related to HNSCC distant metastasis: EIF5A. Our findings were validated using GEO data; EIF5A expression was significantly increased in the tumor tissues of HNSCC patients with distant metastasis. We then predicted miRNAs that can directly bind to EIF5A via the TargetScan and miRWalk websites, intersected them with differentially expressed miRNAs in the two groups from the TCGA cohort, and identified the only overlapping miRNA, miR-424; we predicted the direct binding site of EIF5A and miR-424 via the miRWalk website. Immunohistochemistry further revealed high expression of EIF5A in the primary tumor tissue of HNSCC patients with distant metastasis. These results provide a new perspective for the early diagnosis of distant metastasis in HNSCC patients and the study of the mechanisms underlying HNSCC distant metastasis.