Immunohistochemical staining showed elevated expression of CD163 and Ki-67 in mice treated with QGP-1-H-exo (Fig. 2K), underscoring the contribution of hypoxic pNEN cell-derived exosomes to M2 macrophage polarization and the establishment of an immunosuppressive tumor microenvironment (TME). This evidence concerns the gene MKI67 and neoplasm.