Decoding the associations between cell functional states in head and neck cancer based on single-cell transcriptome

Objectives: Systematically identifying cancer cell functional states, especially their associations, is key to un-derstanding the pathogenesis of cancers.Materials and Methods: Here, we systematically identified six cancer-related states, including epithelial-mesenchymal transition (EMT), immune response, epithelial differentiation, stress, G1/S and G2/M phases, in head and neck squamous cell carcinoma (HNSCC) based on single-cell RNA-sequencing (scRNA-seq).Results and Conclusion: We defined the association patterns between these functional states and found the pat-terns were correlated with the state activity. Particularly, immune response and EMT were negatively, positively, or non-significantly correlated in samples with the highest immune response activity, the lowest activity of the two states, or with the highest EMT activity, respectively. Combining scRNA-seq data of immune cells and four independent HNSCC cohorts, we found the negative relationship between EMT and immune response was correlated with an activated immune microenvironment and a longer survival, while the non-significant rela-tionship was correlated with an immunosuppressed microenvironment and a poor prognosis. Collectively, our results provide insight into the association patterns between functional states in HNSCC, and may facilitate the elucidation of the interactions between cancer cells and immune system during cancer progression.