Association of mature tertiary lymphoid structures with efficacy and prog-nosis of neoadjuvant immunotherapy in gastric cancer
10.3969/j.issn.1009-9905.2025.08.004
- VernacularTitle:成熟三级淋巴结构与胃癌新辅助免疫治疗疗效及预后的关系
- Author:
Zhi-kai LI
1
;
Jian-bo WANG
1
Author Information
1. 山东大学齐鲁医院 肿瘤放疗科(山东 济南 250012)
- Publication Type:Journal Article
- Keywords:
Gastric tumor;
Tertiary lymphoid structures;
Neoadjuvant therapy;
Immunotherapy;
Prognosis
- From:
Chinese Journal of Current Advances in General Surgery
2025;28(8):607-611
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between intratumoral mature tertiary lymphoid structures(mTLS)and the therapeutic efficacy and prognosis in gastric cancer patients receiving neoadjuvant immunotherapy.Methods:A total of 108 patients with gastric adenocarcinoma who underwent radical resection between January 2022 and January 2024 were retrospectively enrolled.All patients received neoadjuvant therapy regimens containing anti-PD-1 antibodies prior to surgery.Based on the presence of mTLS within the tumor or tumor regression bed,pa-tients were categorized into mTLS-positive and mTLS-negative groups.The correlation between mTLS status and clinicopathological features was analyzed.The presence of mTLS was also compared between patients who achieved pathological complete response(pCR)and those with non-pCR after neoadjuvant immunotherapy.Furthermore,asso-ciations between mTLS status,treatment efficacy,and long-term outcomes were assessed.The predictive value of mTLS for clinical outcomes was evaluated using ROC curve analysis.Results:Among the 108 patients,87(80.6%)exhibited intratumoral TLSs,and 52(48.1%)had mature TLSs.The presence of mTLS was significantly associated with greater tumor regression and lower post-treatment ypTNM stage(P<0.001).The mTLS-positive rate was markedly higher in pCR patients than in non-pCR patients(P<0.001).Patients with mTLS positivity demonstrated significantly longer overall survival(HR=3.70,95%CI:2.17-6.33,P<0.001)and recurrence-free survival(HR=4.04,95%CI:2.44-6.70,P<0.001).ROC analysis revealed that the AUCs of mTLS for predicting recurrence and mortality were 0.762(95%CI:0.668-0.856,P<0.001)and 0.740(95%CI:0.645～0.837,P<0.001),respectively.Conclusion:The presence of intratumoral mature tertiary lymphoid structures is significantly associated with tumor regression and favorable clinical outcomes in gastric cancer patients receiving neoadjuvant immunotherapy.mTLS status may serve as a valuable bio-marker for predicting the clinical outcomes of gastric cancer patients receiving neoadjuvant immunotherapy.
