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World J Gastrointest Oncol. Jun 15, 2026; 18(6): 119114
Published online Jun 15, 2026. doi: 10.4251/wjgo.v18.i6.119114
Published online Jun 15, 2026. doi: 10.4251/wjgo.v18.i6.119114
Evolving landscape of the gastric cancer immune microenvironment: From spatial architecture to precision biomarkers
Zhi-Yuan Yao, Zheng-Xiang Han, Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
Li-Jie Ma, The First Clinical College of Xuzhou Medical University, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
Gui-Juan Ji, Department of Pulmonary and Critical Care Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
Co-first authors: Zhi-Yuan Yao and Li-Jie Ma.
Co-corresponding authors: Zheng-Xiang Han and Gui-Juan Ji.
Author contributions: Yao ZY validated and visualized the manuscript, validated and revised the manuscript; Ma LJ wrote and visualized the original draft; Yao ZY and Ma LJ contributed equally to this manuscript as co-first authors; Han ZX designed and revised the original draft; Ji GJ designed and edited the manuscript; Han ZX and Ji GJ contributed equally to this manuscript as co-corresponding authors; all authors read and approved the final manuscript.
AI contribution statement: We use ChatGPT solely for language translation and polishing, and we have engaged a professional language polishing agency to handle the subsequent refinement. Artificial intelligence merely serves to refine language and does not perform automatic generation. Artificial intelligence was employed for language polishing, translation, and framework drafting assistance, but not for data analysis. Artificial intelligence tools were not involved in the design of the research or the interpretation of the results. Any images in the manuscript are not generated by artificial intelligence.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Gui-Juan Ji, PhD, Professor, Department of Pulmonary and Critical Care Medicine, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Xuzhou 221000, Jiangsu Province, China. 190621642@qq.com
Received: January 21, 2026
Revised: February 5, 2026
Accepted: March 5, 2026
Published online: June 15, 2026
Processing time: 140 Days and 22.7 Hours
Revised: February 5, 2026
Accepted: March 5, 2026
Published online: June 15, 2026
Processing time: 140 Days and 22.7 Hours
Core Tip
Core Tip: Gastric cancer therapy must evolve beyond traditional approaches by focusing on the tumor immune microenvironment, which is shaped by spatial architecture, metabolic reprogramming, and microbiota interactions. The reliance on static biomarkers like programmed death-ligand 1 expression is shifting towards dynamic markers, such as tertiary lymphoid structure and circulating tumor DNA, to better predict treatment outcomes. A shift towards “ecosystem engineering” strategies, including vascular normalization, stromal reprogramming, and combination therapies like antibody-drug conjugates and chimeric antigen receptor T cells, is crucial for overcoming immune evasion and improving patient responses.