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. The gene discussed is TNFSF9; the disease is familial pancreatic carcinoma.