Jiang Sutian, Liao Xuhui, Ding Xuzhong
Department of Pathology, Lishui People's Hospital, Lishui, China.
Department of Gastrointestinal Surgery, Lishui People's Hospital, Lishui, China.
Front Med (Lausanne). 2024 Oct 18;11:1435620. doi: 10.3389/fmed.2024.1435620. eCollection 2024.
Tertiary Lymphoid Structures (TLSs) are abnormal clusters of immune cells that form in tissues not normally associated with the immune system, usually in cases of long-lasting inflammation, like cancer. TLSs have been suggested as a potential prognostic indicator in various cancer types.
We retrospectively enrolled 223 gastric cancer (GC) patients who had surgical resections in this study. We utilized hematoxylin and eosin (HE) staining to detect the presence, abundance, and maturity of TLSs. In serial sections, we used immunohistochemistry to examine the cellular composition of TLSs.
The pathological review identified TLSs in 95.1% of the tumors, lymphoid aggregates in 79.8%, primary follicles in 45.7%, and lymphoid aggregates in 95.1% of the cases. Based on Kaplan-Meier curves, the maturation and abundance of TLSs contributed to longer disease-free survival (DFS) and overall survival (OS). In addition, the density of TLSs was strongly associated with the occurrence of tumor metastases and the response to adjuvant chemotherapy.
We validated the prognostic value of TLSs in GC patients in both independent cohorts, and the maturity and density of TLS correlated with tumor metastasis. In addition, TLS may reflect sustained antitumor potency, which has important implications for adjuvant chemotherapy.
三级淋巴结构（TLSs）是在通常与免疫系统无关的组织中形成的异常免疫细胞簇，通常发生在诸如癌症等持续性炎症的情况下。TLSs已被认为是多种癌症类型中的一种潜在预后指标。
我们回顾性纳入了本研究中223例接受手术切除的胃癌（GC）患者。我们利用苏木精和伊红（HE）染色来检测TLSs的存在、丰度和成熟度。在连续切片中，我们使用免疫组织化学来检查TLSs的细胞组成。
病理检查发现95.1%的肿瘤中有TLSs，79.8%有淋巴聚集，45.7%有初级滤泡，95.1%的病例中有淋巴聚集。根据Kaplan-Meier曲线，TLSs的成熟度和丰度有助于延长无病生存期（DFS）和总生存期（OS）。此外，TLSs的密度与肿瘤转移的发生及辅助化疗的反应密切相关。
我们在两个独立队列中验证了TLSs对GC患者的预后价值，且TLSs的成熟度和密度与肿瘤转移相关。此外，TLSs可能反映了持续的抗肿瘤效力，这对辅助化疗具有重要意义。
