Tumor immune microenvironment in cervical cancer: Histological subtype-specific immune landscapes and therapeutic implications.

Cervical cancer is the fourth most common malignancy in women worldwide, with high-risk human papillomavirus (HPV) infection recognized as the predominant etiological factor. Cervical cancer can be classified by HPV status, as HPV-associated or non-HPV-associated, and by histology, which includes squamous cell carcinoma (SCC), adenocarcinoma (ADC), adenosquamous carcinoma, and rare subtypes such as neuroendocrine carcinoma, glassy cell carcinoma, and gastric-type ADC. Recent advances in single-cell and spatial transcriptomics, along with proteomic approaches, have revealed marked heterogeneity in the TIME of different cervical cancer subtypes and highlighted the roles of immune cells and other factors that influence the overall tumor immune responses. This heterogeneity in TIME may critically influence tumor progression, immune evasion, and overall therapeutic responsiveness. Therefore, this review summarizes the immune characteristics of the major histological subtypes of cervical cancer, with a focus on immune cell composition, stromal architecture, and metabolic influences, aiming to provide an integrated understanding that supports more refined and subtype-specific treatment strategies.