Additionally, the observed heterogeneity of T-CTLA-4 expression within PTs in our study, combined with a lack of correlation with other immune markers, supports that CTLA-4 upregulation in tumor cells is mainly induced by intrinsic oncogenic mechanisms, rather than regulated by the surrounding inflammatory microenvironment, as was previously reported for gastric cancer [40]. This evidence concerns the gene CTLA4 and neoplasm.