COX-2 Expression Correlation with Tumor-Associated Macrophages Infiltration and Prognosis in Gastric Cancer

Background Tumor-associated macrophages (TAMs) are the most abundant immune cells in the tumor microenvironment (TME); M1 TAMs have anti-tumor effects, M2 pro-tumor effects. Cyclooxygenase-2 (COX-2) relates to tumor occurrence, development, prognosis and immune infiltration. This study explored COX-2 expression in gastric cancer, its correlation with TAMs and prognostic value, to provide a basis for new immunotherapies. Methods Clinical data and paraffin blocks of 50 gastric cancer patients (25 from the past decade, 25 from the past two years) from the First Affiliated Hospital of Dali University were collected. Immunohistochemistry detected COX-2 expression and infiltration of CD68, CD163, CD4 + T, CD8 + T in tissues. Correlations between COX-2 and immune cells, and survival prognosis in bioinformatics databases were analyzed. Data were processed/visualized using SPSS 26.0. Results 50% of patients showed high COX-2 expression, COX-2 positively correlated with M2 infiltration and CD163. High CD163 indicated better prognosis; CD68 related to poor prognosis. Bioinformatics showed high COX-2 correlated with lower overall survival. Conclusion COX-2 is highly expressed in gastric cancer and positively correlates with M2 infiltration. High COX-2 and low CD163 relate to poor prognosis, providing new ideas for gastric cancer treatment/prevention.