Obesity is a global health problem that has reached epidemic proportions, affecting more than one billion people worldwide and significantly increasing the risk of multiple comorbidities, including type 2 diabetes, cardiovascular diseases, and cancer (World Health Organization, 2024). Increasing evidence suggests that chronic low-grade inflammation associated with obesity plays a critical role in the development of obesity-related malignancies, including gastric cancer. Adipose tissue dysfunction in obesity leads to the recruitment and activation of various immune cells, such as macrophages and mast cells, which contribute to a pro-inflammatory microenvironment through the release of cytokines, growth factors, and angiogenic mediators.
Adult patients undergoing bariatric surgery (laparoscopic sleeve gastrectomy).
BMI > 35 kg/m²
All participants underwent preoperative evaluation, including blood tests and assessment by a multidisciplinary team (nutritionist, psychiatrist, endocrinologist, radiologist, anesthesiologist, and surgeon).
Patients with secondary causes of obesity, such as Cushing's syndrome or polycystic ovary syndrome (PCOS).
Patients with malignant gastric conditions or previous gastric surgery.
Patients with systemic inflammatory diseases, autoimmune disorders, or chronic infections that may influence immune cell infiltration.
Patients with incomplete clinical data or poor-quality tissue samples.