Elevated DTL correlates with immune infiltration and poor prognosis in endometrial carcinoma

The expression profile and function of Denticleless E3 ubiquitin protein ligase (DTL) in uterine corpus endometrial carcinoma (UCEC) have not yet been elucidated. The primary objective of this study is to clarify the differential expression of DTL between normal endometrial tissue and UCEC tissue, thereby providing a foundation for its subsequent functional research. This multi-omics investigation integrated transcriptomic (TCGA/GEO) and proteomic (HPA) profiling with functional annotation (GSEA/KEGG), genomic instability (cBioPortal), epigenetic (MethSurv), and immune infiltration (TIMER2.0/xCell) analyses. DTL exhibited significant upregulation in UCEC compared to normal tissues across transcriptomic and proteomic datasets. Elevated DTL expression was associated with higher histological grade and diminished overall survival. DNA methylation analysis demonstrated hypomethylation at CpG islands within the DTL gene. Immune profiling revealed correlations between DTL expression and cell infiltration. Additionally, low DTL expression was associated with higher immunophenoscores, suggesting a potentially better response to immune checkpoint inhibitors such as anti-CTLA-4 and anti-PD-1/PD-L1 agents. DTL overexpression was significantly associated with adverse clinicopathological features and an immunosuppressive tumor microenvironment in UCEC, suggesting that DTL may hold value as a prognostic biomarker.