Construction of an Immunogenic Cell Death-Related Long Non-Coding RNA Signature for Predicting Prognosis in Osteosarcoma

Immunogenic cell death (ICD), a recently identified form of cell death capable of stimulating the immune system, holds significant potential for cancer therapy. While long non-coding RNAs (lncRNAs) regulate diverse cellular processes, the role and prognostic value of ICD-related lncRNAs (ICDRLs) in osteosarcoma (OS) remain unclear. This study aimed to establish an ICDRL-based prognostic signature for OS. Utilizing gene expression profiles and clinical data from TARGET and GTEx databases, along with published ICD-related genes (ICDRGs), we identified ICDRLs via co-expression analysis, differential expression screening, univariate Cox regression, and LASSO regression. A novel prognostic signature comprising three ICDRLs (ELFN1-AS1, LINC01094, SATB2-AS1) was constructed. The signature demonstrated significant prognostic predictive power, confirmed by receiver operating characteristic curve analysis, and functioned as an independent prognostic factor. Moreover, the signature reflects the tumor immune microenvironment and predicts distinct chemotherapy responses, guiding OS treatment strategies.