Prognostic Tumor-Infiltrating Immune Cell Score in Endometrial Carcinoma

Photo Credit: Md Saiful Islam Khan

Tumor-infiltrating Immune Cell Score as an effective and independent prognostic tool for patients with EC.

In a recent study, authors investigated the prognostic significance of tumor-infiltrating immune cells in endometrial carcinoma (EC).

“The quantity and status of tumor-infiltrating immune cells have been shown to impact patient outcomes in various cancers, including EC,” the study authors explained online in Cancer Reports. “In this study, we aimed to comprehensively analyze the prognostic value of different immune cells in tumor microenvironment and develop a robust predictive model based on immune cells to improve the accuracy of prognosis for EC.”

Using data from The Cancer Genome Atlas (TCGA), the team employed the CIBERSORTx algorithm to assess the abundance of 22 immune cell types in 516 patients with EC. Through Cox regression analysis, they identified CD8+ T cells, resting memory CD4+ T cells, activated NK cells, and activated dendritic cells (DCs) as key prognostic indicators. Of note, these immune cells were integrated into a Tumor-infiltrating Immune Cell Score (TICS), which stratified patients into low-, moderate-, and high-risk groups.

The TICS demonstrated independent prognostic value for overall survival (OS), surpassing traditional clinicopathological factors. Additionally, a nomogram incorporating TICS and clinicopathologic variables was developed, which enhanced prognostic accuracy compared to traditional models.

Immune cells within the tumor microenvironment play critical roles in cancer progression and patient outcomes. Previous studies have highlighted the impact of various immune cell types on EC prognosis, the authors noted, underscoring the need for a comprehensive prognostic model beyond conventional factors.

Through comprehensive analysis of TCGA data, three distinct immune landscape subtypes in EC were categorized, though their correlation with survival was modest. Utilizing CIBERSORTx, we refined our focus to specific immune cell types and developed TICS based on CD8+ T cells, CD4+ T cells, NK cells, and DCs. These components were selected for their significant association with patient survival outcomes. The low-risk subgroup identified by TICS exhibited higher tumor mutation burden and immune response activation, while the high-risk subgroup showed associations with genomic instability and hypoxia.

Study findings suggest that TICS are an effective and independent prognostic tool for patients with EC, complementing existing clinicopathological and molecular classifications. The integration of TICS into clinical practice could enhance prognostic accuracy and guide personalized treatment strategies, particularly in the context of immunotherapy.

“In summary, our study suggests that specific immune cell populations, rather than the overall immune landscape, are associated with the prognosis of patients with EC,” the authors concluded.

“The TICS, which comprises CD8 T cells, resting memory CD4 T cells, activated NK and activated DCs, represents an effective prognostic factor for patients with EC and could be a useful supplement to existing clinicopathological factors and molecular classification.”