Published online Aug 16, 2025. doi: 10.12998/wjcc.v13.i23.105011
Revised: March 24, 2025
Accepted: May 7, 2025
Published online: August 16, 2025
Processing time: 146 Days and 21 Hours
Macrophages play a crucial role in the tumor microenvironment, displaying remarkable plasticity that allows them to either suppress or promote tumor progression. Their polarization into M1 or M2 phenotypes could have significant prognostic implications, and manipulating this polarization may offer a novel approach to controlling colorectal neoplasms.
To evaluate the infiltration rates of M1 and M2 macrophages in colorectal neoplasia, specifically comparing cases with and without metalloproteinase mutations. Additionally, it sought to explore potential prognostic factors as
The study involved two cohorts of patients diagnosed with colorectal neoplasia: 33 patients with metalloproteinase mutations and 33 without. Macrophage quantity and polarization were assessed using markers indicative of M1 (iNOS) and M2 (CD163, CD206) macrophages. Prognostic factors and survival outcomes related to colorectal cancer (CRC) were also analyzed.
Among the 61 patients, 28 (45.9%) exhibited metalloproteinase mutations, while 33 (54.1%) did not. Tumor staging revealed that 16.9% were in stage I, 34.2% in stage II, 42.4% in stage III, and 8.5% in stage IV. The study recorded 12 patient deaths (19.7%), with 21.2% from the control group and 17.9% from the mutation group. M2 macrophages, identified by CD163 and CD206 markers, had mean counts of 23 and 17, respectively, with standard deviations of 21 and 17. In contrast, M1 macrophages, identified by iNOS, had a mean count of five per site, with a standard deviation of 11.
The study found no statistically significant differences in macrophage density between groups, irrespective of metalloproteinase mutation status, age, gender, tumor region, staging, TILS, tumor recurrence, or clinical outcomes. No association was observed between macrophage polarization and CRC prognosis or survival. However, patients with metalloproteinase mutations demonstrated a better survival rate, suggesting a potential protective role of this mutation in colorectal neoplasia.
Core Tip: This study investigates the prognostic significance of macrophage polarization in colorectal cancer (CRC), focusing on patients with and without metalloproteinase mutations. Using M1 (inducible nitric oxide synthase) and M2 (CD163, CD206) markers, macrophage densities were quantified and correlated with survival and clinical outcomes. While no significant differences in macrophage density or polarization were observed between groups, the study highlights a potential protective role of metalloproteinase mutations, as patients harboring these mutations demonstrated improved survival rates. This insight may guide future research into the tumor microenvironment and its implications for CRC prognosis and therapy.