Identification of A Six Immune-Related Genes Prognostic Signature and Exploration of Individual Therapies in Young Women with Cervical Cancer

Abstract

Abstract Cervical cancer (CC) is a great public health problem worldwide, half of CC patients were diagnosed younger than 50 years. However, there is a lack of special research to predict the prognosis of young CC patients and explore individualized treatment. Hence, it’s imperative to identify prognostic biomarkers and explore novel therapeutic strategies for this population. In view of the importance of tumor immunity, here, we screened differentially expressed immune-related genes (DEIRGs) of young CC patients. Functional analyses (GO and KEGG pathway analysis) were processed. Based on a 6-DEIRGs (namely ANGPTL5, CCL18, LCN6, OLR1, PTH2R and UMODL1) signature, we characterized two immune-related groups of young CC patients with distinct prognosis and immune infiltration features. This prognostic model showed excellent performance in internal and external validation. In terms of potential mechanisms and therapeutic strategies, we evaluated the differences in the gene set enrichment analysis (GSEA) and tumor-infiltrating lymphocytes. The differential immune landscape between the two groups was uncovered. Subsequently, the efficacy of immune checkpoint inhibitors (ICI) and target therapy in the two groups were predicted. Intriguingly, we found that significantly higher expression of pivotal immune checkpoint molecules including costimulatory molecules in low-risk group of young CC patients, suggesting the complexity of tumor immune microenvironment in young patients with CC. In conclusion, we constructed a valuable and feasible signature to predict the prognosis of young CC patients, and risk score is also a useful indicator of individualized treatment for this population.