Tumor-associated neutrophils in gastric carcinoma: clinicopathological context and favorable prognosis in women

Autores/as

  • Rosario Caruso Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", Section of Pathological Anatomy, University of Messina
  • Giovanni Tuccari Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", Section of Pathological Anatomy, University of Messina
  • Antonio Ieni Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", Section of Pathological Anatomy, University of Messina
  • Cosimo Inferrera Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", Section of Pathological Anatomy, University of Messina

DOI:

https://doi.org/10.13129/1828-6550/APMB.114.1.2026.SD1

Palabras clave:

Gastric carcinoma, tumor-associated neutrophils (TANs), prognosis, histopathology

Resumen

Neutrophils constitute important effectors of innate immunity, yet their role in malignancy remains controversial. Experimental studies have proposed a dichotomous model of tumor-associated neutrophils (TANs), distinguishing antitumoral N1 from protumoral N2 phenotypes. However, this framework may underestimate the clinicopathological context in which TANs operate in human tumors. This narrative review examines the clinicopathological aspects of TANs in gastric carcinoma. Our prior multivariate Cox analysis demonstrated a significant interaction between neutrophil-rich gastric cancer and sex, indicating a favorable prognostic effect solely in women, and subsequently confirmed by two independent studies. Additionally, our histological analysis showed that TAN density was inversely correlated with Goseki Groups II and IV, subtypes of gastric cancer that are distinguished by increased mucin production. TANs are prevalent in Goseki Group I carcinomas, which are characterized by extensive neutrophil infiltration into neoplastic glands. This infiltration is correlated with pseudobudding and near-complete glandular disruption, which are indicative of an antitumoral function. On the other hand, intraepithelial TAN infiltration in gastric micropapillary carcinoma is associated with tumor cell phagocytosis (cannibalism) of neutrophils, indicating a protumoral interaction. These findings provide support for a contextual approach to TANs in gastric cancer that takes into account the N1/N2 paradigm in addition to sex, histological subtype, mucin production, and tumor microenvironment

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2026-06-22

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Vol. 114 Núm. 1 (2026)

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Derechos de autor 2026 Rosario Caruso, Giovanni Tuccari, Antonio Ieni, Cosimo Inferrera

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