Research Progress and Future Directions in Immune Cell Crosstalk in the Esophageal Cancer: A Bibliometric Analysis.

BACKGROUND: The complexity of immune cell crosstalk plays a key role in immunotherapy resistance for esophageal cancer, while systematically bibliometric analysis in this field to describe knowledge structure, hotspots and identify future research trends remains lacking. METHODS: We retrieved publications on immune cell crosstalk in esophageal cancer from the Web of Science Core Collection, covering 2007 to 2025. A total of 510 articles and reviews were analyzed with CiteSpace and VOSviewer to assess publication trends, collaborative networks, keyword co‑occurrence, citation bursts, and research hotspots. RESULTS: Research output has grown sharply since 2020. China, the United States, and Japan are the top three countries by productivity. Keyword analysis showed a progression from basic mechanisms such as apoptosis and the NF-κB pathway toward immunotherapy combinations, tumor-associated macrophages (TAMs), and cancer-associated fibroblasts (CAFs). Crosstalk networks involving T cells and macrophages are now relatively well understood, whereas interactions between regulatory T cells (Tregs) and natural killer cells (NK cells) remain poorly defined. In addition, most studies have focused on chemo-immunotherapy, leaving the cellular crosstalk under radiotherapy-based treatments largely unstudied. CONCLUSION: Our findings suggest that future research may benefit from prioritizing the study of Tregs and NK cells crosstalk in patients receiving radiotherapy-based treatments, and from examining their interactions with other cells, particularly TAMs and CAFs.