Our study found that the high-risk group exhibited elevated infiltration of M0 macrophages, and several immune checkpoints, including CD274 (PD-L1), CD276, CD44, and TNFSF9, were also elevated in patients with high CARGs scores, which may be associated with the immunosuppressive microenvironment characteristics of pancreatic cancer. Here, CD274 is linked to familial pancreatic carcinoma.