This complex immune cell distribution pattern reveals a dynamic balance between immune activation and suppression in the CM microenvironment, the increase in CD8+ T cells and activated CD4+ T cells reflects anti-tumor immune activation, while the simultaneous rise in Tregs and macrophages M1 may collectively shape an immunosuppressive TME through immune checkpoint molecules (e.g., CTLA-4, PD-1) and pro-inflammatory cytokine secretion (Wei et al., 2018). Here, CTLA4 is linked to neoplasm.