ONCOLOGY / EXPERIMENTAL RESEARCH
The relationship of the tertiary lymphoid structures with the tumor-infiltrating lymphocytes and its prognostic value in gastric cancer
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1
Center for Regenerative and Reconstructive Medicine, Med-X Institute of Western China Science & Technology Innovation Harbour, The First Affiliated Hospital of Xian JiaoTong University, China
2
National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, China
3
Institute for Cancer Research School of Basic Medical Science of Xi’an Jiaotong University, China
4
Department of Pathology, The First Affiliated Hospital of Xi’an Jiaotong University 710061, China
5
Department of Science and Technology, The First Affiliated Hospital of Xi’an Jiaotong University, China
Submission date: 2020-10-24
Final revision date: 2021-07-01
Acceptance date: 2021-07-30
Online publication date: 2021-08-02
Corresponding author
Yili Wang
Institute for Cancer Research School of Basic Medical Science of Xi’an Jiaotong University, 76 YanTa West Road,, 710061, Xi’an,, China
Arch Med Sci 2024;20(1)
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ABSTRACT
Introduction:
To explore the relationship between the tertiary lymphoid structures (TLSs) and tumor-infiltrating lymphocytes (TILs), and their distribution characteristics as well as the prognostic value in gastric cancer (GC).
Material and methods:
The TLSs and four subtypes of TILs were assessed by immunohistochemical (IHC) staining. The presence of MECA-79 positive high endothelial venules (HEVs) identified among the ectopic lymphocyte aggregation area in the GC tissue was defined as valid TLSs. The number of labeled TILs was observed in 5 fields of the most positive cells in the tumor center, invasive edge and within the TLSs, at a field of vision ×40.
Results:
The TLS distribution was significantly higher in the tumor invasive edge than the tumor center (p < 0.001). Similarly, the infiltrating density of CD8+T cells and GrB+T cells was statistically significantly higher in the tumor infiltrating edge than the tumor center. The total number of TILs and FOXP3+T cells showed a contrary distribution. There was a positive correlation of the density of TLSs and TILs with both the location and the immune phenotype. A higher frequency of TILs and TLSs is often associated with favorable clinicopathologic parameters. Higher numbers of peri-TLSs (p = 0.007), peri-CD8+(p = 0.019) and peri-GrB+TILs (p = 0.032) were significantly correlated with the favorable overall survival. Multivariate analysis revealed that the densities of TILs (p = 0.019) and TLSs (p = 0.037) were independent prognostic predictor for GC patients.
Conclusions:
We provide evidence that TLSs were positively associated with lymphocyte infiltration in GC. Thus, the formation of TLSs predicts advantageous immune system function and can be considered as a novel biomarker to stratify the overall survival risk of untreated GC patients.