Abstract
Endometrial cancer (EC) is the sixth most common malignant tumor in women worldwide, and its morbidity and mortality are on the rise. The purpose of this study was to explore potential tumor microenvironment (TME)-related biomarkers associated with the clinical features and prognosis of EC. The Estimating Stromal and Immune Cells in Malignancy Using Expression Data (ESTIMATE) algorithm was used to calculate TME immune and stromal scores of EC samples and to analyze the relationship between immune/stromal scores, clinical features, and prognosis. Heat maps and Venn maps were used to screen for differentially expressed genes (DEGs). The ESTIMATE algorithm revealed immune score was significantly correlated with overall survival and tumor grade in patients with EC. A total of 1448 DEGs were screened, of which 387 were intersecting genes. Gene Ontology (GO) analysis revealed that the biological processes (BP) related to intersecting genes mainly included T cell activation and regulation of lymphocyte activation. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that the intersecting genes were closely related to immune-related signaling pathways. Thirty core genes with more than 7 nodes were identified using protein-protein interaction (PPI) analysis. Six independent prognostic genes of EC were identified using Kaplan-Meier survival analysis and multivariate Cox analysis, namely CD5, BATF, CACNA2D2, LTA, CD52, and NOL4, which are all immune-infiltrating genes that are closely related to clinical features. The current study identified 6 key genes closely related to immune infiltration in the TME of EC that predict clinical outcomes, which may provide new insights into novel prognostic biomarkers and immunotherapy for patients with EC.