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ORIGINAL RESEARCH article

Front. Immunol.

Sec. Cancer Immunity and Immunotherapy

This article is part of the Research TopicImmunological Aspects and Immunotherapy in Gynecologic CancersView all 33 articles

APOs as promising prognostic biomarkers: correlation with tumor-infiltrating leukocytes in endometrial cancer

Provisionally accepted
Lina  ZhouLina Zhou1Rencheng  WangRencheng Wang2Guiqiang  DuGuiqiang Du3Yupeng  WuYupeng Wu4Hui  LiHui Li3Yinyan  HeYinyan He4Zhikang  YeZhikang Ye4Jiangdong  XiangJiangdong Xiang1*
  • 1Shanghai General Hospital, Shanghai, China
  • 2Baoshan Renhe Hospital, Baoshan, China
  • 3Shanghai First Maternity and Infant Hospital, Shanghai, China
  • 4Shanghai Tenth People's Hospital, Shanghai, China

The final, formatted version of the article will be published soon.

ABSTRACT Background Apolipoproteins (APOs) are essentially structural and functional components of lipoproteins, which are composed of 22 members and their effects on certain types of cancer have been studied. However, their roles in endometrial cancer (EC), which is one of the most common malignant tumors in gynecology were unclear and rarely investigated. Methods We investigated the expression levels of APOs genes in EC. Furthermore, we explored the roles of APOs in prognostic value, and immune infiltrates in EC patients by using different bioinformatics databases. In-vitro experiments were also conducted to evaluate the effect of APOs genes expression on migrant abilities of EC cells. Results Nine APO genes (APOC1, APOC2, APOC4, APOD, APOE, APOL3, APOL4, APOLD1, and APOO) were found differently expressed between EC and control tissues by the GEPIA2. However, APOC4 was not included in the subsequent analysis due to its low expression in EC tissues. Moreover, mRNA expression levels of APOs were found correlated with the clinicopathological characteristics of EC, including stage, grade, molecular subgroups, p53 mutant conditions, PTEN mutant conditions, and expression levels of ESR1 and ESR2. Meanwhile higher expression levels of APOs were significantly correlated with better (APOD, APOL3) or poorer (APOC1, APOE, APOLD1) OS. ssGSEA showed 7 TILs in EC which differed significantly from those in adjacent noncancerous tissues were correlated with prognosis of EC patients. The expression levels of both APOD and APOE were positively correlated with all 7 TILs. Finally, western blotting showed that 17β-estradiol (E2) increased APOE protein expression level and reduced APOD protein expression level. Furthermore, APOE was identified to promote the cell migration by scratch assay. Conclusion The expression of APOs may be a promising prognostic biomarker and is associated with immune invasion as a potential target for endometrial cancer.

Keywords: Apolipoproteins, biomarkers, endometrial cancer, prognostic, Tumor-infiltrating leukocytes

Received: 14 Jun 2025; Accepted: 27 Jan 2026.

Copyright: © 2026 Zhou, Wang, Du, Wu, Li, He, Ye and Xiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Jiangdong Xiang

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