肿瘤组织及间质组织中免疫细胞的浸润谱及其水平预测胃癌患者预后:一项回顾性队列研究OA

Background and purpose:Most existing studies have focused on single immune cell types,lacking systematic analyses of the global immune cell infiltration landscape within tumor parenchyma and stroma.This study aimed to investigate the clinical significance of regional heterogeneity in immune cell infiltration.Methods:This study retrospectively collected clinical specimens and the corresponding clinical information from gastric cancer patients who were treated in Nantong Third People's Hospital from March 2004 to July 2009 and met the inclusion and exclusion criteria of this study.This study used immune cell surface markers to identify 8 types of immune cells in the tissues(CD3+cells,CD3+CD4+cells,CD3+CD8+cells,CD3+FOXP3+cells,CD68+cells,CD66b+cells,CD11b+cells,and CD45RO+cells).We separately analyzed the expression levels of these immune cells in tumor and stromal compartments,as well as their clinical significance.This retrospective cohort study was approved by the Ethics Committee of Nantong Third People's Hospital(approval No.EK2025062)and the informed consents of the patients were acquired.Results:A total of 405 patients who met the inclusion criteria were finally included in this study.The infiltration level of CD68+cells showed significant differences across different tumor stages,grades,and histological differentiation statuses(P<0.05).Both stromal CD68⁺ cells[hazard ratio(HR)=0.971,95%CI:0.960-0.982,P<0.001]and tumor CD68⁺ cells(HR=1.012,95%CI:1.006-1.018,P<0.001)exhibited robust predictive efficacy for patient survival outcomes,and were identified as independent prognostic factors for gastric cancer.Moreover,stromal CD68 ⁺ cell infiltration levels were significantly correlated with the expression of immune checkpoints,including cytotoxic T-lymphocyte-associated antigen 4(CTLA-4),programmed cell death-1(PD-1),programmed cell death-ligand 1(PD-L1)and lymphocyte-activation gene 3(LAG3,P<0.05).Conclusions:High infiltration of CD68⁺ cells in the stromal compartment and low infiltration of CD68⁺ cells in the tumor parenchyma conferred favorable prognostic value for gastric cancer patients.This study provided a region-specific framework for future investigations targeting CD68⁺ cells.