Tertiary lymphoid structures and gastric cancer prognosis

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 canc...

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Published in:APMIS : acta pathologica, microbiologica et immunologica Scandinavica microbiologica et immunologica Scandinavica, 2023-01, Vol.131 (1), p.19-25
Main Authors: Kemi, Niko, Ylitalo, Olli, Väyrynen, Juha P., Helminen, Olli, Junttila, Anna, Mrena, Johanna, Böhm, Jan, Kauppila, Joonas H.
Format: Article
Language:English
Subjects:
Cancer
Density
Gastric cancer
Humans
Immune response
inflammation
lymphocyte
Medical prognosis
Medicin och hälsovetenskap
Original
Population studies
Prognosis
Reproducibility of Results
Stomach Neoplasms - diagnosis
Subgroups
Survival
tertiary lymphoid structure
Tertiary Lymphoid Structures - pathology
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Summary: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.
ISSN:0903-4641
1600-0463
1600-0463
DOI:10.1111/apm.13277