IMR Press / CEOG / Volume 50 / Issue 10 / DOI: 10.31083/j.ceog5010204
Open Access Original Research
Identification of an Immune Cell Infiltration-Related Prognostic Model to Guide Immunotherapy in Endometrial Carcinoma
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1 NHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, 200237 Shanghai, China
2 State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, 200237 Shanghai, China
*Correspondence: liyunsun@ecust.edu.cn (Liyun Sun); xhni_sippr@163.com (Xiaohua Ni); henrywuqh@hotmail.com (Qihan Wu)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2023, 50(10), 204; https://doi.org/10.31083/j.ceog5010204
Submitted: 21 March 2023 | Revised: 25 May 2023 | Accepted: 5 June 2023 | Published: 9 October 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Uterine corpus endometrial carcinoma (UCEC) is a prevalent gynaecologic malignancy. It has been demonstrated that the immune cell infiltration (ICI) pattern plays a critical role in the tumour progression of UCEC. Methods: To further investigate the immune microenvironment landscape of UCEC, we analysed the gene expression data of 539 UCEC patients from The Cancer Genome Atlas (TCGA) database using CIBERSORT and ESTIMATE for consensus clustering of immune cells. We used the limma package to compare differentially expressed genes (DEGs) among ICI patterns and constructed a prognostic model using Cox regression to calculate the risk score of UCEC patients. The immunophenoscore was downloaded to explore the immunotherapeutic effect between low- and high-risk score patients. Finally, the tumour mutation burden (TMB) was calculated using the somatic mutation data. Results: We identified two different immune infiltration patterns in 539 UCEC samples, the immune-desert and immune-inflamed phenotypes, which had distinct prognostic and biological features. We obtained 29 DEGs to construct the ICI-related prognostic model and established a four ICI-related gene-based prognostic model comprising LINC01871, CXCL13, IGKJ5, and LINC01281. The risk score was associated with distinct clinical outcomes, ICI, and immunotherapeutic effects. Patients with a low risk score had higher effective immune cells, which could be classified into the immune-inflamed phenotype. Additionally, patients with a low risk score had a significantly higher immunophenoscore, suggesting a better immunotherapeutic outcome. Finally, TMB was confirmed to be associated with prognosis, which was synergistic with the risk score. Conclusions: This study comprehensively analysed the ICI pattern in UCEC patients and established a four ICI-related gene-based prognostic model to predict prognosis and guide precise immunotherapy strategies.

Keywords
uterine corpus endometrial carcinoma
immune cell infiltration
prognostic model
immunotherapy
Funding
81872103/National Natural Science Foundation of China
20204Y0274/Shanghai Municipal Health Commission Funds
202140339/Shanghai Municipal Health Commission Funds
CX2022-03/Innovation-oriented Science and Technology Grant from NHC Key Lab of Reproduction Regulation
Figures
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