SPP1 and cervical adenocarcinoma: Disruption of DHCR7 attenuated macrophage-mediated immunosuppression and alleviated CD8<sup>+</sup> T cell exhaustion.<h4>Conclusions</h4>This study identifies a DHCR7-27-HC-SPP1 metabolic-immune axis that drives immune escape in HPV-negative cervical adenocarcinoma, highlighting cholesterol metabolism as a potential therapeutic vulnerability.