Identification and Validation of a Novel Lactylation-related Gene Signature to Predict the Prognosis of Endometrial Cancer

Endometrial carcinoma (EC) is a prevalent kind of cancerous tumor with significant morbidity and mortality. Mounting evidence reveals that lactylation modification plays a crucial role in tumorigenesis, but its connection to EC remains poorly understood. This study aimed to identify a lactylation-related gene signature to predict the prognosis of EC. Differentially expressed lactylation-related genes between EC and normal samples were analyzed using the TCGA database. Univariate and LASSO Cox regression analyses were employed to construct the lactylation-related signature, which was then validated using both the test set and entire set. A nomogram was further developed and evaluated. Additionally, enrichment analysis, immune cell infiltration, tumor mutation burden and drug response were assessed between the two risk groups. Sixteen lactylation-related genes (LRGs) were selected to construct the prognostic signature. Kaplan-Meier survival curves showed that patients in the high-risk group had remarkably worse prognosis. A nomogram based on the signature and other clinical characteristics was constructed and demonstrated strong predictive power. Additionally, biological pathways, immune status, tumor mutation burden and drug response differed between the high- and low-risk groups. In conclusion, our study demonstrated that the LRG signature is a promising biomarker for EC, effectively distinguishing high-risk patients, predicting prognosis, and offering new strategic directions for antitumor immunotherapy.