Tertiary lymphoid structures and gastric cancer prognosis

Abstract

Tertiary lymphoid structures (TLSs) are part of immune response against cancer. Their high density and high diameter have been shown to be associated with prognosis in different cancer types. The aim of this study was to examine the prognostic significance of TLS density and diameter in gastric cancer and reproducibility of their assessments. TLS densities and maximal TLS diameter were assessed from hematoxylin–eosin (HE) stained slides of 721 surgically treated gastric cancer patients from two hospitals in Finland. Mortality hazard ratios (HRs) for TLS densities and maximal TLS diameter were analyzed. TLS densities and maximal TLS diameter were assessed with moderate interobserver agreement (Cohen's kappa 0.50–0.62). Maximal TLS density was not associated with survival (adjusted HR 0.85, 95% CI 0.70–1.02) and neither was hotspot TLS density (adjusted HR 0.85, 95% CI 0.70–1.02). High maximal TLS diameter was associated with longer survival in overall study population (adjusted HR 0.74, 95% CI 0.61–0.89) and in diffuse type subgroup (adjusted HR 0.65, 95% CI 0.50–0.85). In conclusion, high maximal TLS diameter is associated with improved survival in gastric cancer and can be assessed from HE‐stained slides. Its prognostic value might be limited to diffuse histological type.

The Prognostic Significance of Tertiary Lymphoid Structure Assessment with Hematoxylin and Eosin Sections in Esophageal Squamous Cell Carcinoma

“…Thus, our practice proved that H&E section assessment is very potential in ESCC for TLS evaluation and prognostic prediction. However, the density and diameter pro les showed certain association with overall survival both in our and TCGA datasets, they can't be used as predictive biomarkers in ESCC, which is unlike that in gastric cancer (Kemi et al 2023) and colorectal carcinoma (Wang et al 2022a). This divergence underscores the inherent heterogeneity prevalent across various cancer types.…”

Analyzing the associations between tertiary lymphoid structures and postoperative prognosis, along with immunotherapy response in gastric cancer: findings from pooled cohort studies

“…1 ), 106 records were identified from public databases in the initial literature search. After carefully screening titles and abstracts, and subsequent full-text review, 11 studies incorporating 4224 GC samples were ultimately enrolled (Yu et al 2022 ; Li et al 2020 ; Yin et al 2022 ; Jiang et al 2022 ; Li et al 2023 ; Kemi et al 2023 ; Mori et al 2022 ; Cheng et al 2021 ; Mori et al 2021 ; Yamakoshi et al 2021 ; He et al 2020 ). Baseline information and major characteristics are shown in Table 1 .…”

Prognostic value of tertiary lymphoid structures (TLS) in digestive system cancers: a systematic review and meta-analysis

“…Absence No OS, DFS Ling YH [ 31 ] 2022 China ESCC 394 I-III 2008–2017 Median:68.57 month HE、IHC TLS Presence vs. Absence No OS, DFS Jiang Q [ 32 ] 2022 China GC 292 I-IV 1983–2016 Until 2020.1 HE、IHC Mature TLS High vs. Low Yes OS Kemi N [ 33 ] 2022 Finland GC 721 I-IV 2002–2008 Median: 28.0 month HE TLS diameter High vs. Low NA OS Zhan Z [ 34 ] 2022 China CRC 203 I-IV 2014.01–2017.07 Median: 50.0 month IHC TLS High vs. None or Low Yes OS, DFS Li JH [ 35 ] 2022 China HCC 150 I-...…”