Exploration of tumor-infiltrating immune cells on the prognosis of endometrial cancer

Setting: ：Immune cells played a vital role in the progression of endometrial cancer, whereas immunologic mechanism and clinical prognostic biomarkers remained to be identified. Objective: To explore the landscape of tumor-infiltrating immune cells in endometrial cancer and the correlation between TIICs and EC prognosis. Methods: Data of 530 patients was downloaded from TCGA. CIBERSORTx estimated the abundance of immune cells. Ranked data used Spearman coefficient to measure the relationship between immune cells and clinical characteristics. Univariate COX hazard analysis was performed to explore the relationship between immune cells and clinical outcomes. Lasso regression was used to screen variables. Multivariate regression was performed for stepwise regression variable screening. Univariate and multivariate Independent prognosis analysis was performed to validate the reliability of the multivariate risk model. A nomographic chart was used to grade and assess each patient’s prognosis. Results: 11 type TIICs were increased in cancer tissues(P<0.05). Univariable regression revealed that 5 types TIICs were significantly related with EC prognosis. TTMMD model was constructed via lasso regression and multivariable cox regression. Log-rank was used to perform survival analysis, and the result was presented by Kaplan-Meier curve(p=5.13e-03). The Roc curve was simultaneously fulfilled to validate the model’s accuracy and predictability(AUC=0.676). The Kaplan-Meier curve of the training set was statistically significant(p=3.807e-02). ROC curve replied the feasibility of the model(AUC=0.678). The risk model was an independent factor for predicting EC prognosis(p<0.001). Conclusion: 11 types TIICs were significantly associated with the prognosis of endometrial cancers. The immune-cells-based risk model was reliable for prognosis assessment.