CMTM6 recruits T cells within the endocervical adenocarcinoma microenvironment and suppresses cell proliferation via the p53 pathway

Abstract Endocervical adenocarcinoma (ECA), harboring poor prognosis, is divided into human papilloma virus (HPV)‐associated adenocarcinoma (HPVA) and non‐HPVA (NHPVA), each consisting of a heterogeneous immune microenvironment. We aim to examine the effect of CKLF‐like MARVEL transmembrane domain 6 (CMTM6), a key regulator of PD‐L1, on ECA. Immunohistochemistry and RNA‐sequencing (RNA‐seq) were used to detect CMTM6, Programmed death ligand 1 (PD‐L1), and immune cells biomarkers levels in tumors. RT‐qPCR and Western Blotting were used to detect the mRNA and protein level changed in cells. The expression of CMTM6 in ECA is upregulated compared to cervical squamous cell carcinoma tissues. More infiltrating T cells were observed in CMTM6 high ECA tissues, especially in CMTM6 high HPVA. Higher expression of CMTM6 is associated with a higher rate of infiltrating CD8 + T cells in HPVA, but not in NHPVA. ECA patients were divided into three groups according to the co‐expression status of CMTM6 and PD‐L1 (CPS) . Patients with CMTM6 high /PD‐L1 (CPS+) had the longest OS and DFS, especially in NHPVA patients. Moreover, knock down of CMTM6 promotes ECA cell proliferation via the p53 pathway. CMTM6 recruits T cells, suppresses ECA cell proliferation via the p53 pathway and can be used as a novel prognostic indicator for ECA patients.