Introduction This study aimed to investigate the role of CD47 in type 2 endometrial cancer and its relationship with macrophage infiltration and patient prognosis.

Methods A retrospective study was conducted on 75 patients with type 2 endometrial cancer who underwent hysterectomy between 2002 and 2017 at Nagoya University Hospital. Formalin-fixed paraffin-embedded tissue samples were collected and stained for CD47, CD68, and CD163 to assess macrophage infiltration. The correlation between CD47 expression, macrophage infiltration, and patient prognosis was analyzed.

Results CD47 expression was not significantly associated with prognosis in type 2 endometrial cancer. However, higher CD47 expression in tumor cells was significantly associated with fewer CD68 macrophages at the tumor margins. A poorer prognosis was observed in patients with more CD68 macrophages and fewer CD163 macrophages at the tumor margins compared to the other patients. No significant differences were observed in age, stage, or histological type.

Conclusion/Implications CD47 expression may not be a reliable prognostic factor for type 2 endometrial cancer. However, higher CD47 expression in tumor cells was found to be associated with fewer CD68 macrophages at the tumor margins, and a greater number of CD68 macrophages and a lower number of CD163 macrophages at the tumor margins were poor prognostic factors. Further investigation into the association between CD47 expression and macrophage subtypes in endometrial cancer is warranted.