Prognostic Value of IL21, CXCL9 and CD1A in Cervical Cancer

Abstract Background Cervical cancer is one of the most common malignant tumors of the female reproductive system. Existing treatments provide limited benefit for patients with advanced, recurrent or metastatic disease, and reliable prognostic markers are lacking. In this study we integrated multi-omic data from The Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) database. Protein-coding genes meeting the criteria of an adjusted P value < 0.05 and |log 2 fold-change| > 5 were screened; 693 genes were identified. We further focused on three genes related to the tumor microenvironment—interleukin 21 (IL21), C-X-C motif chemokine ligand 9 (CXCL9) and cluster of differentiation 1A (CD1A)—and performed differential expression analysis, survival analysis, clinical stage analysis and immune infiltration correlation analysis to clarify their prognostic value and potential mechanisms in cervical cancer. Results (1) CXCL9 and CD1A were highly expressed in cervical cancer tissues, and all three genes showed high expression across different pathological stages without stage-dependent differences; (2) high expression of IL21, CXCL9 and CD1A improved patient prognosis and was positively associated with overall survival (OS), disease-specific survival (DSS) and progression-free interval (PFI); (3) expression of IL21, CXCL9 and CD1A was closely correlated with infiltration of multiple immune cells: IL21 correlated with total T cells, helper T cells and B cells, CXCL9 correlated with T cells and activated dendritic cells, and CD1A correlated with immature dendritic cells. Conclusion IL21, CXCL9 and CD1A are potential prognostic biomarkers and key immunomodulatory factors in cervical cancer. This study provides a new direction for immunotherapy and individualized precision treatment of cervical cancer.