Abstract:
Objective To investigate the characteristics and prognostic value of tertiary lymphoid structures (TLS) in gastric neuroendocrine neoplasms (g-NEN) and to construct and validate a prognostic nomogram.
Methods We retrospectively collected the clinical data from 140 patients with g-NEN at Nanjing Drum Tower Hospital from 2013 to 2021. We firstly analyzed the characteristics of TLS by HE&immunohistochemical staining and then univariate and multivariate Cox analysis using SPSS 22.0 software was performed to derive independent risk factors; Lastly, we constructed a nomogram and validated its efficacy by using R studio.
Results The median age of the 140 g-NEN patients was 62.5 (51, 69.25) years; 84 (60%) were male and 56 (40%) were female; the median of TLS density was 0.0694 cells per mm2 (0.01585, 0.19775); 64 (45.7%) were g-NET, 76 (54.3%) were g-NEC/g-MiNEN; TNM stage Ⅰ/Ⅱ was 80 (57.1%), 60 (42.9%) was Ⅲ/Ⅳ, vascular invasion was 56 (40%), and neurological invasion was 47 (33.6%). TLS were mainly located in the tumor margin or stroma region and have three different mature shapes. TLS density, WHO classification and TNM stage were independent prognostic factors (P<0.05). The nomogram has high degree of discrimination, calibration and clinical practicability.
Conclusion The TLS density is an independent prognostic factor of g-NEN and the nomogram incorporating TLS density has good predictive performance and clinical application.
Key words:
Gastric Neuroendocrine Neoplasms,
Tertiary Lymphoid Structures,
Clinicopathological Features,
Prognosis,
Nomogram
Daming Cai, Xiaofeng Lu, Xingzhou Wang, Meng Wang, Song Liu, Xuefeng Xia, Xiaofei Shen, Junfeng Du, Wenxian Guan. Predictive value of tertiary lymphoid structures in the prognosis of patients with gastric neuroendocrine neoplasms[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(04): 401-405.