ArticleJournal of the National Cancer Institute2026
An immunosuppressive tertiary lymphoid structure is associated with adverse prognosis in gastric-type endocervical adenocarcinoma.
Article in Journal of the National Cancer Institute, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Tertiary lymphoid structures guided opportunities and challenges for immunotherapy in early gastroesophageal junction cancer and low rectal cancer.Human vaccines & immunotherapeutics · 2026Review
- Prognostic Significance of the Tumour Microenvironment in Surgically Resected Canine Pulmonary Adenocarcinomas.Veterinary and comparative oncology · 2026Article
- A Tissue Virus Microenvironment with Activated Stress Responses Underlies Durable SIV Persistence.bioRxiv : the preprint server for biology · 2026Article
- High PD-L1 expression as a negative prognostic factor in stage III but not in stage II gastric cancer.World journal of gastroenterology · 2026Article
- Immune remodeling during cervical cancer chemoradiotherapy: temporal biomarkers and the timing of checkpoint blockade.Frontiers in immunology · 2026Review
- Targeting regulatory T cell plasticity in gastric cancer: a unified bimodal model and precision immunotherapy paradigm: a hypothesis-generating review.Frontiers in oncology · 2026Article
- Tertiary lymphoid structure topotypes in intrahepatic cholangiocarcinoma: spatial immunity, checkpoint-response associations, and therapeutic reprogramming.Frontiers in immunology · 2026Review
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Abstract
backgroundGastric-type adenocarcinoma (GAC) is the predominant subtype of HPV-independent endocervical adenocarcinoma, characterized by aggressive clinical behavior and poor prognosis. However, its tumor immune microenvironment (TIME) remains largely unexplored.
methodsWe systematically profiled the immune landscape using bulk RNA sequencing and multiplex immunofluorescence staining and comprehensively analyzed the associations between immune features, clinicopathological parameters, and patient outcomes in a multi-institutional cohort of 153 GAC cases.
resultsGAC tumors exhibited sparse T cell but abundant macrophage infiltration, predominantly with M2-polarized macrophages in advanced stage. Tumors with tertiary lymphoid structure (TLS) demonstrated an immunosuppressive milieu characterized by enrichment of B cells, PD1-CD8+ T cells, and regulatory T cells. While TLS-positive patients were associated with poorer prognosis, 2 patients showed improved survival with chemoradiotherapy. Moreover, the TLS and FIGO stage-based prognostic model was robust in the risk stratification for tumor recurrence.
conclusionsWe reveal a distinct immunosuppressive TIME and TLS in GAC. TLS might confer an adverse prognosis. Our findings provide valuable clues for individualized therapy for this aggressive cancer in future.
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