A prognostic model based on immune cells in tumor microenvironment to
predict prognosis in endometrial cancer
Abstract
Objective: The interaction between tumor immune
microenvironment (TIME) and malignant tumor cells plays a crucial role
in the occurrence and development of tumors. This study aimed to
establish and validate a prognostic model based on TIME characteristics
for prognosis prediction and personalized treatment guidance of patients
with endometrial cancer (EC). Methods: 67 EC patients who
underwent surgery and TIME detection between January 2018 and December
2022 at Peking University People’s Hospital were included. A prognostic
model was established according to the density of CD3+ cell and CD8+
cell. 200 EC patients as the validation set, we used
immunohistochemical(IHC) markers CD3+cell and CD8+ cell, verified the
accuracy of the prognostic model. Results: (1) Time was
detected by multiplex immunofluorescence(mIF) in 67 EC patients from
Peking University People’s Hospital, There were statistical difference
between the Recurrence group and Non-Recurrence group in density of
PD-L1+ cell, CD8+ cell, CD68+CD163+ cell, CD3+ cell and CD56+ cell.
Among them, the difference of CD3+ cell was the most significant(
P=0.004); (2)In 514 EC patients from TCGA database, There was
statistical difference between the Recurrence group and Non-Recurrence
group in CD8+ cell, regulatory T cells (Tregs) and Dendritic cells
activated(DC activated),Among them, the difference of CD8+ cell was the
most significant( P=0.000); (3) CD3+cell and CD8+cell were
selected as modeling factors to establish a prognostic model, the
patients were divided into Cluster 1 (n=17), Cluster 2 (n=39) and
Cluster 3 (n=11). Survival analysis difference( P=0.006) of the
three groups were statistically significant; (4)The three Clusters has
differences in other immune cells, molecular typing and
clinicopathological characteristics; (5) 200 EC patients from Peking
University People’s Hospital as the validation set, using IHC markers
CD3+cell and CD8+ cell, the patients were divided into Cluster 1,
Cluster 2, and Cluster 3 for survival analysis, which had statistical
significance ( P=0.000) and verified the accuracy of the
prognostic model. Conclusion: Based on TIME, this study found
two immune cells that are significantly related to the prognosis of EC,
and established an EC prognostic model based on this, with good
prediction efficiency and accuracy.