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author:

Ding, Y. (Ding, Y..) [1] | Yu, M. (Yu, M..) [2] | Xue, M. (Xue, M..) [3] | Zong, W. (Zong, W..) [4] | Huang, Y. (Huang, Y..) [5] | Ren, J. (Ren, J..) [6] | Guo, T. (Guo, T..) [7] | Sun, D. (Sun, D..) [8] | Pan, X. (Pan, X..) [9]

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Scopus

Abstract:

Lung adenocarcinoma (LADC) exhibits high spatial heterogeneity, with distinct spatial variations in pathological features. The distribution of tertiary lymphoid structures (TLS) in LADC is uneven, and different TLS characteristics play unique roles. To investigate the correlation between TLS features and other pathological characteristics, particularly tumor spread through air spaces (STAS), we analyzed TLS and other pathological features on whole-slide images stained with HE and CD20/CD23. Additionally, the 14-Gene assay was used to assess prognostic risk. Among 388 enrolled LADC patients, 226 (58.2%) were TLS-positive. TLS showed a negative correlation with various adverse pathological features, with boundary-area TLS demonstrating the strongest correlation with STAS quantity (r= -0.324, P < 0.001). Multivariate Cox analysis identified boundary-area TLS as an independent prognostic factor for recurrence-free survival (HR = 0.856, 95% CI = 0.759–0.966, P = 0.026), while mature TLS was an independent factor for overall survival (HR = 0.841, 95% CI = 0.717–0.988, P = 0.035). High-density TLS at the tumor boundary was associated with low-risk stratification by the 14-Gene assay (P = 0.013). This study highlights the negative correlation between TLS and STAS, especially in boundary areas, and emphasizes the impact of tumor microenvironment spatial characteristics on clinical outcomes. Assessment of spatial heterogeneity in LADC facilitates precise risk stratification for patients. © The Author(s) 2025.

Keyword:

Lung adenocarcinoma Spatial characteristics Tertiary lymphoid structures Tumor spread through air spaces

Community:

  • [ 1 ] [Ding Y.]Department of Thoracic Surgery, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, No. 134, East Street, Fuzhou, 350001, China
  • [ 2 ] [Ding Y.]Shengli Clinical Medical College of Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
  • [ 3 ] [Yu M.]Shengli Clinical Medical College of Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
  • [ 4 ] [Yu M.]Department of Ophthalmology, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
  • [ 5 ] [Xue M.]Clinical School of Thoracic, Tianjin Medical University, Tianjin, China
  • [ 6 ] [Xue M.]Department of Pathology, Tianjin Chest Hospital, Tianjin, China
  • [ 7 ] [Zong W.]Clinical School of Thoracic, Tianjin Medical University, Tianjin, China
  • [ 8 ] [Zong W.]Department of Pathology, Tianjin Chest Hospital, Tianjin, China
  • [ 9 ] [Huang Y.]Department of Thoracic Surgery, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, No. 134, East Street, Fuzhou, 350001, China
  • [ 10 ] [Huang Y.]Clinical School of Thoracic, Tianjin Medical University, Tianjin, China
  • [ 11 ] [Ren J.]Clinical School of Thoracic, Tianjin Medical University, Tianjin, China
  • [ 12 ] [Ren J.]Department of Thoracic Surgery, Tianjin Jinnan Hospital, Tianjin, China
  • [ 13 ] [Guo T.]Department of Thoracic Surgery, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, No. 134, East Street, Fuzhou, 350001, China
  • [ 14 ] [Guo T.]Shengli Clinical Medical College of Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
  • [ 15 ] [Sun D.]Clinical School of Thoracic, Tianjin Medical University, Tianjin, China
  • [ 16 ] [Sun D.]Department of Thoracic Surgery, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Tianjin, 300222, China
  • [ 17 ] [Pan X.]Department of Thoracic Surgery, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, No. 134, East Street, Fuzhou, 350001, China
  • [ 18 ] [Pan X.]Shengli Clinical Medical College of Fuzhou University Affiliated Provincial Hospital, Fuzhou, China

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Source :

World Journal of Surgical Oncology

ISSN: 1477-7819

Year: 2025

Issue: 1

Volume: 23

2 . 5 0 0

JCR@2023

CAS Journal Grade:3

Cited Count:

WoS CC Cited Count:

SCOPUS Cited Count:

ESI Highly Cited Papers on the List: 0 Unfold All

WanFang Cited Count:

Chinese Cited Count:

30 Days PV: 2

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