The identification of prognostic and predictive markers is crucial for choosing the most appropriate management method for ovarian cancer patients. We aimed to assess the prognostic role of tumor-associated macrophage (TAM) polarization in advanced ovarian cancer patients. We carried out a prospective observational study that included 140 consecutive patients with advanced-stage high-grade serous ovarian cancer as well as patients with other histotypes of ovarian cancer and patients with ovarian metastasis from other sites between June 2013 and December 2018. Patients were enrolled at the time of laparoscopic surgery before receiving any antineoplastic treatment. We found that patients with high-grade serous papillary ovarian cancers had a prevalence of M1 TAMs, a higher M1/M2 ratio, and a longer overall survival (OS) and progression-free survival (PFS) than other patients. Regression analysis confirmed that there was a significant positive association between the M1/M2 ratio and an improved OS, PFS and platinum-free interval (PFI), both in the entire population and in patients stratified according to tumor type and initial surgery. Kaplan-Meier analysis was performed after the patients were divided into 2 groups according to the median M1/M2 ratio and revealed that patients with a high M1/M2 ratio had a higher OS, PFS and PFI than those with a low M1/M2 ratio. In conclusion, the prognostic and predictive role of TAM polarization in the tumor microenvironment could be of great clinical relevance and may allow the early identification of patients who are likely to respond to therapy. Further studies in a larger prospective sample are warranted.

预后和预测指标的识别对于选择最适合卵巢癌患者的治疗方法至关重要。我们旨在评估晚期卵巢癌患者中肿瘤相关巨噬细胞（TAM）极化的预后作用。我们进行了一项前瞻性观察性研究，该研究纳入了2013年6月至2018年12月期间连续140例晚期高级别浆液性卵巢癌患者以及其他组织类型的卵巢癌患者和其他部位的卵巢转移患者。在接受任何抗肿瘤治疗之前进行腹腔镜手术时。我们发现患有高度浆液性乳头状卵巢癌的患者的M1 TAM患病率较高，M1 / M2比率较高，与其他患者相比，其总生存期（OS）和无进展生存期（PFS）更长。回归分析证实，在整个人群以及根据肿瘤类型和初次手术分层的患者中，M1 / M2比率与OS，PFS和无铂间隔（PFI）改善之间存在显着的正相关。根据中位数M1 / M2比率将患者分为两组后进行Kaplan-Meier分析，结果显示，M1 / M2比率高的患者比M1 / M2比率低的患者具有更高的OS，PFS和PFI 。总而言之，TAM极化在肿瘤微环境中的预后和预测作用可能具有重大的临床意义，并可能有助于及早发现可能对治疗产生反应的患者。