CXCL8 producing macrophages shape gastric cancer outcomes

BACKGROUND: Gastric cancer (GC) remains a major cause of cancer-related mortality worldwide, highlighting the need for reliable prognostic biomarkers. Although chemokines critically regulate the tumor microenvironment (TME), their integrated prognostic value and mechanistic roles in GC remain unclear. We aimed to develop a chemokine-based prognostic signature and elucidate its underlying cellular basis. METHODS: Transcriptomic data from TCGA and GEO cohorts were integrated to construct and validate a prognostic model using least absolute shrinkage and selection operator (LASSO) Cox regression based on six differentially expressed chemokines. Associations between the risk score and TME characteristics, tumor mutation burden (TMB), and drug sensitivity were evaluated. Single-cell RNA sequencing (scRNA-seq) was performed to determine the cellular origin and functional role of the key chemokine CXCL8. RESULTS: A six-chemokine signature stratified patients into high- and low-risk groups with significantly different overall survival (OS; p = 0.003) and progression-free survival (PFS; p < 0.001). The risk score was an independent prognostic factor, and the corresponding nomogram demonstrated good predictive performance (C-index = 0.680). The high-risk group exhibited elevated TMB and reduced chemosensitivity. scRNA-seq analysis identified macrophages as the principal source of CXCL8. These CXCL8-high macrophages displayed a pro-tumorigenic phenotype and functioned as key communication hubs within the TME, particularly through SPP1 signaling. CONCLUSION: This chemokine-based signature provides clinically relevant prognostic stratification in GC and implicates the CXCL8-macrophage axis as a potential therapeutic target.