Helicobacter pylori is associated with less tumor-infiltrating lymphocytes and a poor prognosis in gastric cancer

BMC Gastroenterol. 2025 May 30;25(1):420. doi: 10.1186/s12876-025-04003-w.

Abstract

Background: Helicobacter pylori (H. pylori) is carcinogenic and has the potential to cause progressive gastric lesions and gastric cancer (GC), which also represents one of the essential constituents of the tumor microenvironment (TME) of GC. The infiltration and functional status of tumor-infiltrating lymphocytes (TILs) in the TME affect the anti-tumor function of the body. However, the impact of H. pylori on anti-tumor immunity and prognosis of GC is still unclear.

Methods: In this study, we constructed a tissue microarray (TMA) consisting of GC tissues from patients with or without H. pylori infection. We evaluated the status of TILs and the expression of CD3, CD8 and PD-L1 by Hematoxylin-eosin (H&E) staining and immunohistochemical (IHC) staining, respectively. Correlation, Cox regression, and survival analyses were performed.

Results: We found that TIL, CD3, and CD8 were negatively correlated with H. pylori infection. In addition, TILhigh and CD8+TILs status were positively associated with better survival. Simultaneously, patients with H. pylori-positive status had decreased survival compared to those in the H. pylori-negative group.

Conclusions: Our study supports the hypothesis that H. pylori infection was positively correlated with less TILs and CD8+TILs, which may contribute to anti-tumor immune escape, thus lead to a poor prognosis of GC.

Keywords: Helicobacter pylori; Gastric cancer; Immune escape; Prognosis; Tumor infiltrating lymphocytes.

MeSH terms

  • Adult
  • Aged
  • B7-H1 Antigen / metabolism
  • CD3 Complex / metabolism
  • CD8 Antigens / metabolism
  • CD8-Positive T-Lymphocytes / immunology
  • Female
  • Helicobacter Infections* / complications
  • Helicobacter Infections* / immunology
  • Helicobacter pylori*
  • Humans
  • Lymphocytes, Tumor-Infiltrating* / immunology
  • Male
  • Middle Aged
  • Prognosis
  • Stomach Neoplasms* / immunology
  • Stomach Neoplasms* / microbiology
  • Stomach Neoplasms* / mortality
  • Stomach Neoplasms* / pathology
  • Tissue Array Analysis
  • Tumor Microenvironment / immunology

Substances

  • CD3 Complex
  • CD8 Antigens
  • B7-H1 Antigen
  • CD274 protein, human