Prognostic impact of tumour budding, stromal phenotype, and CD163-positive macrophages in intestinal-type gastric adenocarcinoma.

The tumour microenvironment plays an important role in the progression of gastric adenocarcinoma, but the prognostic value of its histopathological and immunological components in intestinal-type tumours remains unclear. This retrospective study included 100 patients who underwent gastrectomy for intestinal-type gastric adenocarcinoma. Tumour budding, stromal phenotype, tumour-stroma ratio, and lymphocytic infiltration were assessed on haematoxylin-eosin-stained sections, and immunohistochemical analyses of CD68, CD163, L-caldesmon, and periostin were performed at the invasive front. Tumour budding was associated with invasion depth and tumour stage but showed no independent prognostic significance. A myxoid stromal phenotype was independently associated with improved overall survival and reduced recurrence risk. CD163-positive macrophage density exceeded CD68 density and was independently linked to better survival. L-caldesmon expression was rare and not associated with clinicopathological parameters. Periostin expression correlated with macrophage infiltration but not with survival outcomes. These findings suggest that stromal phenotype and tumour-associated macrophages, particularly CD163-positive cells, have prognostic relevance in intestinal- type gastric adenocarcinoma.