Clinical implications and molecular features of tertiary lymphoid structures in stage I lung adenocarcinoma

期肺腺癌三级淋巴结构的临床意义和分子特征

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作者:Xuejun Xu, Yifeng Gao, Shanzhou Duan, Qifeng Ding, Xiaofan Wang, Xiaoxiao Dai, Yongsheng Zhang, Yongbing Chen, Donglai Chen

Aims

We investigated the clinical implications and molecular features of TLS in stage I lung adenocarcinoma (LUAD).

Conclusion

The presence of TLS was an independent favorable factor for patients with stage I LUAD. The presence TLS was featured by special immune profiles which might aid oncologists in determining personalized adjuvant treatment.

Methods

We retrospectively reviewed the clinicopathological characteristics of 540 patients with p-stage I LUAD. Logistic regression analysis was applied to determining the relationships between clinicopathological features and the presence of TLS. TLS-associated immune infiltration pattern and signature genes were characterized using the transcriptomic profiles of 511 LUADs from The Cancer Genome Atlas (TCGA) database.

Results

The presence of TLS was associated with a higher pT stage, low- and middle-grade patterns, and the absence of tumor spreading through air spaces (STAS) and subsolid nodules. Multivariate Cox regression analysis identified that the presence of TLS was associated with favorable overall survival (OS) (p < 0.001) and recurrence-free survival (RFS) (p < 0.001). Subgroup analysis showed that the most favorable OS (p < 0.001) and RFS (p < 0.001) favored the TLS + PD-1- subgroup. The presence of TLS was characterized by abundance in antitumor immunocytes including activated CD8+ T and B cells as well as dentritic cells in TCGA cohort.

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