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Pancreatic ductal adenocarcinoma is a relatively aggressive disease. Tumor-associated macrophages (TAMs) have been shown to have an effect on tumor progression and as a prognostic marker in numerous solid tumors. Our goal was to determine the significance of TAMs in the pancreatic cancer microenvironment and the prognostic value of TAMs in pancreatic cancer. The distribution of TAMs in tissues of primary tumors, surrounding tissues, and tumor-draining lymph nodes were analyzed by immunohistochemistry using CD68. The association between TAMs and clinicopathological factors, recurrence, and survival were evaluated. Macrophages were found predominantly in the tumor tissue and to a lesser extent in the surrounding tissues. They were positively associated with the pT stage (P = 0.000), pN stage (P = 0.000), and pM stage (P = 0.001). High TAMs scores were associated with a poorer prognosis (P = 0.000), even in the subgroup analysis, including age (P = 0.002) and tumor differentiation (P = 0.041). In univariate analysis, the presence of TAMs was also found to be independently associated with recurrence (P = 0.000), but there was no significant association in multivariate analysis. TAMs were more prevalent in pancreatic cancer tissues than in the surrounding tissues. High TAMs expression was significantly associated with tumor-draining lymph node metastasis, recurrence, and poor survival in the multivariate analysis. These findings suggest that TAMs might be involved in pancreatic cancer invasion and metastasis. However, TAMs did not provide additional prognostic information beyond that of tumor staging.The US National Marine Fisheries Service, an agency of the US Department of Commerce, will soon be proposing to open up an Atlantic port in the US from 2019 to 2024
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