Prognostic signature construction and immunotherapy response analysis for Uterine Corpus Endometrial Carcinoma based on cuproptosis-related lncRNAs

As a general female malignant tumor, Uterine Corpus Endometrial Carcinoma (UCEC) has high mortality and relapses. Cuproptosis was found to play an essential role in tumor by more and more researches. However, it is still unclear of the prognostic value and function of cuproptosis related Long non-coding RNA (lncRNA) in UCEC. Sequencing data with the corresponding clinical data and cuproptosis-related genes (CRGs) data were obtained from the Cancer Gene Atlas (TCGA) database and cuproptosis related studies. Pearson test was applied to select cuproptosis-related lncRNAs (CRLs). Prognosis associated CRLs was identified by univariate Cox analysis and the predictors were determined by least absolute shrinkage and selection operator (Lasso)-Cox and multivariate Cox analyses to construct the cuproptosis-related lncRNA prognostic signature (CRLPS). The performance of the CRLPs was evaluated by consistency index (C-index) and Kaplan-Meier analysis. A nomogram model was constructed for survival prediction and the accuracy of the model was evaluated by calibration curve. Finally, immune related analyses were applied to predict immune responses and identify drugs with potential efficacy for the overall survival (OS). A total of 734 CRLs were found and 29 of them were identified as prognosis related lncRNAs. 12 CRLs were finally determined to build the CRLPS which revealed good ability on prognosis predicting. Subsequently, risk score of the CRLPS and grade were assessed as independent prognosis factors for UCEC, based on which the prognostic model provided the highest prediction accuracy of 99.7%. The calibration curve suggested that the prediction results consisted well with the observation. Enrichment analysis showed the CRLPS was mainly associated with tumor development and immune response. Patients in low tumor mutation burden (TMB) group had poorer OS. Significant difference was found in tumor immune dysfunction and exclusion (TIDE) score between different risk score groups. Finally, based on the CRLPs, drug sensitivity analysis identified nine anticancer drugs with potential efficacy on prognosis. Cuproptosis-related lncRNA prognostic signature was constructed for UCEC for the first time. Its high reliability and accuracy on predicting prognosis and immunotherapy response provided new perspective to explore the tumor mechanism and improve clinical prognosis. Nine discovered sensitive drugs provided important clues for personalized treatment of UCEC.