Construction of a ferroptosis-related lncRNA signature for predicting prognosis, immune response and drug sensitivity in cervical squamous cell carcinoma and endocervical adenocarcinoma

Ferroptosis, a recently identified cell death mode, has been shown to play critical roles in several malignant tumors. Long non-coding RNAs (lncRNAs) have been reported to modulate ferroptosis, thereby affecting the growth and prognosis of cancers. However, the association between lncRNA and ferroptosis in cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) remains unclear. The aim of this study was to identify ferroptosis-related lncRNAs (FRLs) associated with CESC prognosis and investigate their interaction with tumor immune response. R software and Perl were used to screen for aberrant expressed FRLs associated with CESC patient prognosis from The Cancer Genome Atlas (TCGA) database, including AP003774.2, SOX21 antisense divergent transcript 1 (SOX21-AS1), myocardial infarction associated transcript (MIAT), RUSC1 antisense RNA 1 (RUSC1-AS1), AC004847.1, AC009097.2, MIR100 host gene (MIR100HG), AC083799.1, long intergenic non-protein coding RNA 958 (LINC00958), AC009065.8 and AC131159.1. A risk score was calculated for each CESC patient individual according to the expression levels of 11 FRLs, based on which a prognostic model was built. Kaplan-Meier (K-M) survival curve analysis and Receiver Operating Characteristic (ROC) curve assessment were conducted to determine the predictive accuracy of the prognostic model. Lastly, the R software and CIBERSORT were employed to examine the differences in immune cell infiltration, immune checkpoint and drug sensitivity between the two subgroups. The 11 FRLs were used to construct a prognostic model that classified CESC patients into a high-or low-risk group. The FRL-based model was found to outperform traditional clinicopathological features in predicting CESC patient survival. Significant variations existed across subgroups in immune cell infiltration, immunological function, overall survival (OS), and inhibitory concentrations (IC50 values). Our findings provide novel insights into the role of FRLs in CESC and present a personalized predictive tool for determining patient prognosis, immune response and drug sensitivity.