Relationship between Farnesoid X Receptor and Macrophage Polarization Status in Colorectal Cancer

Abstract Purpose: Colorectal cancer exhibits insensitivity to immunotherapy, which may be associated with the polarization state of macrophages in the immune microenvironment. This study aims to investigate the expression of the Farnesoid X receptor in colorectal cancer, and analyze its correlation with clinical pathological features and the polarization state of macrophages. Methods: Immunohistochemistry was performed to detect the expression of FXR in colorectal cancer tissues, as well as the infiltration of M1 and M2 macrophages. Statistical analysis was conducted to explore the relationship between farnesoid X receptor expression and clinical pathological characteristics, as well as macrophage polarization status. Results: The positive rates of farnesoid X receptor in tumor cells and tumor stroma were 29.03% and 45.16%, respectively. The expression of farnesoid X receptor in tumor cells was associated with tumor location. The expression of farnesoid X receptor in tumor stroma was associated with the polarization status of macrophages, with a higher infiltration of M1 macrophages and a higher M1/M2 ratio in the farnesoid X receptor-positive group, indicating better immunotherapy outcomes and a favorable prognosis. Conclusion: farnesoid X receptor is expressed in both colorectal cancer tumor cells and tumor stroma, and is closely related to the clinical pathological characteristics and immune microenvironment of colorectal cancer.