Effect of tertiary lymphoid structures on pathological response and prognosis after neoadjuvant therapy for non-small cell lung cancer
10.12354/j.issn.1000-8179.2024.20240462
- VernacularTitle:三级淋巴结构对非小细胞肺癌患者新辅助治疗后病理反应及预后的影响
- Author:
Xue MENGLI
1
,
2
;
Geng HUA
;
Li SHIXIONG
;
Ding YUN
;
Xu MEILIN
Author Information
1. 天津医科大学胸科临床学院(天津市 300041)
2. 天津市胸科医院病理科
- Keywords:
tertiary lymphoid structure(TLS);
tumor infiltrating lymphocyte(TIL);
non-small cell lung cancer(NSCLC);
neoadjuvant therapy
- From:
Chinese Journal of Clinical Oncology
2024;51(9):454-460
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the effect of tertiary lymphoid structures(TLS)on the pathological response and prognosis of patients with non-small cell lung cancer(NSCLC)receiving neoadjuvant therapy.Methods:We retrospectively collected the data of 132 patients with NSCLC who underwent neoadjuvant therapy and surgery at Tianjin Chest Hospital between January 2019 and December 2023,including 40 in the neoadjuvant chemotherapy(NC)group and 92 in the NC plus immunotherapy(NCI)group.The percentage of residual viable tumor(RVT)and tumor infiltrating lymphocyte(TIL)counts were evaluated by hematoxylin and eosin(H&E)staining,while TLS number and matur-ity were assessed by H&E and immunohistochemical staining.The differences in TLS number and maturity and effects on patient pathologic-al response and prognosis were compared between groups.Results:TIL count,total TLS number,pathological complete response and major pathological response rates were significantly higher in the NCI versus NC group(P<0.001).Moreover,a multivariate Logistic analysis sho-wed that TLS number and maturity and TIL count affected pathological response in the NCI group(P<0.05).A multiple linear regression ana-lysis indicated that a low TIL count was a risk factor for a high RVT in the NC group,while a low number of mature TLS,low TIL count,and N stage were independent risk factors for a high RVT in the NCI group(all P<0.05).In the NCI group,a multivariate Cox regression analysis showed that a low number of mature TLS(P=0.001)and low TIL count(P=0.009)were independent predictors of disease-free survival(DFS),while a survival analysis showed that patients in the NCI group with high(vs.low)numbers of mature TLS and a high(vs.low)TIL count had significantly longer DFS(all P<0.001).Conclusions:A low number of mature TLS and low TIL count were associated with an adverse patholo-gical response and short DFS in patients with NSCLC.Thus,TLS maturity and TIL count can predict the pathological response and prognosis of patients with NSCLC treated with NCI.
