Exploration of the Correlation Between GRHL1 Expression and Tumor Microenvironment in Endometrial Cancer and Immunotherapy

Suyang Guo,1 Wenqi Bai,1 Fengjie Cui,1 Xin Chen,1 Xiaojing Fang,1 Honghong Shen,2 Xianhua Gu1 1Department of Gynecology Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu, People’s Republic of China; 2Department of Medical Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu, People’s Republic of ChinaCorrespondence: Honghong Shen, Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical University, Anhui Province Key Laboratory of Translational Cancer Research, Bengbu Medical University, 287 Changhuai Road, Bengbu, Anhui, 233004, People’s Republic of China, Tel +8613385681156, Email shenhonghong1984@163.com Xianhua Gu, Department of Oncology Gynecology, The First Affiliated Hospital of Bengbu Medical University, Bengbu Medical University, 287 Changhuai Road, Bengbu, Anhui, 233004, People’s Republic of China, Tel +8613385680722, Email guxianhua1986@163.comIntroduction: GRHL1 belongs to the family of Grainyhead-like (GRHL). Previous studies have shown that dysregulation of growth and survival pathways is associated with the GRHL family of gene cancers. Immunotherapy with checkpoint inhibitors has changed the treatment paradigm for many tumors, including endometrial cancer (EC). However, the effect of GRHL1 on immunotherapy in EC and its relationship with immune cell infiltration are poorly understood.Methods: Differential expression of GRHL1 between EC and normal EC tissues was analyzed by searching the TCGA database, and the results were verified utilizing immunohistochemistry analyses. Next, the relationship between GRHL1, CD8+ T cells and tumor microenvironment (TME) was also investigated, and the effect of GRHL1 expression on immunotherapy in EC was evaluated.Results: According to the findings, EC tissues had elevated expression levels of GRHL1 relative to normal tissues. Patients with EC who expressed GRHL1 at high levels experienced worse overall survival (OS) and Progression-free survival (PFS) than those whose expression was lower. In addition, GRHL1 expression was negatively correlated with CD8+ T cells, and patients with high GRHL1 expression were less effective in receiving immunotherapy.Conclusion: The expression of GRHL1 was high in EC patients, and high expression of GRHL1 inhibits the proliferation of CD8+ T cells in the tumor microenvironment of EC and affect the efficacy of immunotherapy.Keywords: GRHL1, endometrial cancer, tumor microenvironment, CD8+ T cells, immunotherapy