Abstract
OBJECTIVE: Uterine endometrial cancer (UCEC) is a major cause of morbidity and mortality in women, with a complex immune microenvironment influencing tumor progression and prognosis. This study aims to evaluate the prognostic significance of immune scores in UCEC, characterize immune cell infiltration patterns, and investigate the role of IGHV3-30 in the immune microenvironment and its association with clinical outcomes. METHODS: We performed bioinformatics analyses using TCGA data from 541 UCEC patients. Patients were stratified into high- and low-immune score groups based on optimal cutoffs determined by receiver operating characteristic (ROC) analysis. Immune microenvironment profiling was conducted using CIBERSORT and ESTIMATE algorithms. Differentially expressed genes (DEGs) were identified and analyzed for their association with immune cell infiltration, tumor stage, and prognosis. Somatic mutation analysis was also conducted to examine the relationship between IGHV3-30 expression and genetic alterations. RESULTS: High immune scores were significantly associated with favorable overall survival in UCEC patients, and decreased with advancing tumor stage.High expression of IGHV3-30 was significantly associated with favorable overall survival (OS) in UCEC patients. IGHV3-30 was identified at the intersection of differentially expressed genes (DEGs) and differentially mutated genes (DMGs) between immune groups.Additionally, IGHV3-30 expression correlated positively with the infiltration of immune cells such as M1 macrophages and plasma cells, and negatively with memory B cells and activated dendritic cells. Mutation analysis revealed that IGHV3-30 expression was linked to somatic mutations in key tumor suppressor genes. CONCLUSION: Immune scores serve as valuable prognostic indicators in UCEC. IGHV3-30, predominantly expressed in B-cell lineages, demonstrates potential as a prognostic biomarker associated with favorable outcomes and distinct immune infiltration patterns. These findings provide insights for future immunotherapy strategies, though experimental validation is warranted.