The tumor microenvironment is surrounded by blood vessels and consists of malignant, non-malignant, and immune cells, as well as signalling molecules, which primarily affect the therapeutic response and curative effects of drugs in clinical studies. Tumor-infiltrating immune cells participate in tumor progression, impact anticancer therapy, and eventually lead to the development of immune tolerance. Immunotherapy is evolving as a promising therapeutic intervention to stimulate and activate the immune system to suppress cancer cell growth. Endometrial cancer (EC) is an immunogenic disease, and in recent years, immunotherapy has shown benefit in the treatment of recurrent and advanced EC. This review discusses the key molecular pathways associated with the intra-tumoral immune response and the involvement of circulatory signalling molecules. Specific immunologic signatures in EC which offer targets for immunomodulating agents, are also discussed. We have summarized the available literature in support of using immunotherapy in EC. Lastly, we have also discussed ongoing clinical trials that may offer additional promising immunotherapy options in the future. The manuscript also explored innovative approaches for screening and identifying effective drugs, and to reduce the financial burdens for the development of personalized treatment strategies. Collectively, we aim to provide a comprehensive review of the role of immune cells and the tumor microenvironment in the development, progression, and treatment of EC.

肿瘤微环境被血管包围，由恶性、非恶性和免疫细胞以及信号分子组成，在临床研究中主要影响药物的治疗反应和疗效。肿瘤浸润免疫细胞参与肿瘤进展，影响抗癌治疗，并最终导致免疫耐受的发展。免疫疗法正在发展成为一种有前途的治疗干预措施，可以刺激和激活免疫系统以抑制癌细胞的生长。子宫内膜癌（EC）是一种免疫原性疾病，近年来，免疫疗法在治疗复发性和晚期子宫内膜癌方面显示出疗效。本综述讨论了与肿瘤内免疫反应相关的关键分子途径以及循环信号分子的参与。还讨论了 EC 中为免疫调节剂提供靶点的特定免疫学特征。我们总结了支持在 EC 中使用免疫疗法的现有文献。最后，我们还讨论了正在进行的临床试验，这些试验可能在未来提供更多有前途的免疫治疗选择。该手稿还探讨了筛选和识别有效药物的创新方法，并减少制定个性化治疗策略的财务负担。总的来说，我们的目标是对免疫细胞和肿瘤微环境在 EC 的发生、进展和治疗中的作用进行全面综述。