The tumor immune microenvironment in long-term survival resected pancreatic cancer patients
This study aimed to elucidate immunological and microbial factors contributing to prolonged survival in pancreatic ductal adenocarcinoma (PDAC) patients, providing valuable guidance for treatment strategies that enhance efficacy. To accomplish this, we performed metatranscriptomics analyses and IF staining analyses to map the TIME in PDAC tumors from treatment-naïve short-term survivors (a cancer-specific survival of shorter than six months, STS) and long-term survivors (a cancer-specific survival over five years, LTS). In conclusion, our study unveiled a distinctive, yet intricate tumore immune microenvironment associated with prolonged survival in PDAC. This profile includes a decrease in pro-tumoral M2 and M0 macrophages, along with an increase in plasma B cells, all linked to a better prognosis in PDAC. Future research should be directed towards a more comprehensive understanding of the role of B cells in pancreatic cancer and the modulation of M2 macrophage polarization. Such insights will be invaluable in tailoring personalized therapeutic strategies to enhance patient outcomes. Overall design: To understand the prerequisites for long-term survival following surgical resection in PDAC patients, we performed the metatranscriptomic analyses and multiplex immunofluorescence, between STS and LTS.  Surgical specimens were formalin-fixed paraffin-embedded (FFPE) and stored. Patients were treatment-naive prior to surgery.