Alterations in Mast Cell and Macrophage Infiltration, as Well as Micro Vessel Density

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.

Inclusion Criteria: * 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). Exclusion Criteria: * 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. * Patients taking anti-inflammatory, immunosuppressive, or corticosteroid therapy within the last 3 months before sampling.