Evolving landscape of the gastric cancer immune microenvironment: From spatial architecture to precision biomarkers

doi:10.4251/wjgo.v18.i6.119114

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Jun 15, 2026; 18(6): 119114
Published online Jun 15, 2026. doi: 10.4251/wjgo.v18.i6.119114

Table 3 Integrative landscape of molecular subtypes and immune phenotypes

Molecular subtype	Spatial phenotype	Key genomic drivers	Dominant immune mechanism	Recommended strategy
Epstein-Barr virus+	Inflamed (hot)	9p24.1 amp, PIK3CA mut	Viral pathogen-associated molecular patterns; constitutive programmed death-ligand 1	Programmed cell death protein 1 monotherapy
Microsatellite instability	Inflamed (hot)	Deficient mismatch repair, high tumor mutational burden	Neoantigen-driven recruitment	Dual checkpoint blockade
Genomically stable	Excluded (cold)	CDH1/RHOA mut, CLDN18.2	TGF-β fibrosis; myofibroblastic cancer-associated fibroblasts barriers	Anti-CLDN18.2/TGF-β inhibitors
Chromosomal instability	Desert/variable	TP53 mut, receptor tyrosine kinase amp, somatic copy number alterations	Human leukocyte antigen loss of heterozygosity; myeloid-driven suppression	Targeted + immune checkpoint inhibitors (e.g., human epidermal growth factor receptor 2-directed)

TGF-β: Transforming growth factor beta.

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Citation: Yao ZY, Ma LJ, Han ZX, Ji GJ. Evolving landscape of the gastric cancer immune microenvironment: From spatial architecture to precision biomarkers. World J Gastrointest Oncol 2026; 18(6): 119114
URL: https://www.wjgnet.com/1948-5204/full/v18/i6/119114.htm
DOI: https://dx.doi.org/10.4251/wjgo.v18.i6.119114

Yao ZY, Ma LJ, Han ZX, Ji GJ. Evolving landscape of the gastric cancer immune microenvironment: From spatial architecture to precision biomarkers. World J Gastrointest Oncol 2026; 18(6): 119114 [DOI: 10.4251/wjgo.v18.i6.119114]

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