Abstract
In the present study, we explored the clinical and immunological characteristics of 575 uterine corpus endometrial carcinoma (UCEC) samples obtained from The Cancer Genome Atlas (TCGA) using the ESTIMATE and CIBERSORT algorithms. First, Kaplan–Meier and univariate Cox regression analyses indicated that the immune cell score was a prognostic factor for overall survival (OS) and recurrence-free survival (RFS). Multivariate Cox regression analysis further revealed that the immune cell score was an independent prognostic factor for UCEC patients. Second, we investigated the correlation between the infiltration levels of 22 types of immune cells and the immune score. Survival analysis based on the 22 immune cell types showed that higher levels of regulatory T cell, activated NK cell, and follicular helper T-cell infiltration were associated with longer OS, while higher levels of CD8+ T cell and naive B-cell infiltration were associated with longer RFS. Next, we performed differential expression and prognosis analyses on 1534 immune-related genes and selected five from 14 candidate genes to construct a prognostic prediction model. The area under the receiver-operating characteristic (ROC) curve (AUC) for 3- and 5-year survival were 0.711 and 0.728, respectively. Further validation using a stage I–II subgroup showed similar results, presenting AUC values for 3- and five-year survival of 0.677 and 0.692, respectively. Taken together, the present study provides not only a deeper understanding of the relationship between UCEC and the immune landscape but also guidance for the future development of UCEC immunotherapy.
Highlights
Uterine corpus endometrial carcinoma (UCEC) is the seventh most commonly diagnosed cancer in women worldwide [1]
The immune score was significantly associated with UCEC prognosis
Our results further showed that there was no significant correlation between immune score and important clinical variables (Figure 1C–E), further supporting that the immune score was an independent prognostic factor
Summary
Uterine corpus endometrial carcinoma (UCEC) is the seventh most commonly diagnosed cancer in women worldwide [1]. 75% of patients with endometrial cancer are diagnosed at an early stage, and local lesions can, to a large extent, be cured by surgery. We systematically evaluated the prognostic value of immune cell infiltration and immune-related genes in UCEC. We first used the ESTIMATE algorithm to assess the impact of the immune score on clinical features and prognosis of UCEC. We identified several immune-related genes involved in tumor development that could affect prognosis, and established a predictive model with five immune-related genes to assess disease prognosis and patient survival. This is the first and most comprehensive study concerning the clinical, molecular, and immunological characteristics of UCEC. We believe that this report will improve the understanding of the immune landscape in UCEC
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