# High UBE2D1 expression is associated with poor prognosis and immunotherapy resistance in head and neck cancer

## TL;DR

UBE2D1 overexpression in head and neck cancer is linked to worse survival and possible resistance to immunotherapy.

## Contribution

This study identifies UBE2D1 as a potential prognostic biomarker and explores its role in immunotherapy resistance in HNSCC.

## Key findings

- UBE2D1 is significantly overexpressed in HNSCC compared to normal tissues.
- Higher UBE2D1 levels correlate with poorer overall and relapse-free survival.
- UBE2D1 is associated with oncogenic pathways and may influence tumor progression.

## Abstract

Head and neck squamous cell carcinoma (HNSCC) is an aggressive malignancy with poor clinical outcomes. Ubiquitin-conjugating enzyme E2 D1 (UBE2D1), a key component of the ubiquitination machinery, has been implicated in tumor progression in several cancers; however, its relevance in HNSCC remains unclear. This study aimed to investigate UBE2D1 expression in HNSCC, evaluate its prognostic significance while acknowledging disease heterogeneity, including HPV and TP53 status, and explore its potential association with response to anti-PD-1 immunotherapy.

UBE2D1 mRNA and protein expression were analyzed using the Cancer Genome Atlas Head and Neck Squamous Cell Carcinoma (TCGA-HNSCC) dataset via the UALCAN platform. Transcript-level expression was validated by quantitative real-time PCR in paired HNSCC and adjacent normal tissues. Protein–protein interaction and functional enrichment analyses were performed to examine UBE2D1-associated molecular networks. Prognostic relevance was assessed using Kaplan–Meier survival analysis.

UBE2D1 mRNA and protein expression were significantly elevated in HNSCC compared with normal tissues (P < 0.05). Higher UBE2D1 expression was associated with poorer overall and relapse-free survival. Exploratory analyses suggested a weak association between elevated UBE2D1 expression and response patterns to anti-PD-1 therapy. Functional analyses identified associations with oncogenic pathways, with UBE2D1 expression positively correlated with MMP2 and negatively correlated with SMAD4, indicating a potential role in tumor progression.

UBE2D1 is frequently overexpressed in HNSCC and is associated with adverse clinical outcomes. Although its association with immunotherapy response requires further validation, UBE2D1 may be a prognostic biomarker in HNSCC.