ArticleGastroenterology report2026
Secondary follicle-like TLS as a protective factor in pMMR rectal cancer: insights into its regional distribution and prognostic value.
Article in Gastroenterology report, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Mismatch repair-proficient rectal cancer (pMMR RC) is characterized by limited effective therapeutic options and an unfavorable prognosis, largely attributed to the complexity of the tumor immune microenvironment. Tertiary lymphoid structures (TLSs), which are ectopic lymphoid aggregates that develop within tumors, constitute a crucial component of this microenvironment and have shown considerable prognostic significance. However, the maturation heterogeneity of TLS subtypes within the tumor immune microenvironment, as well as their associations with clinicopathological characteristics and patient outcomes, remain poorly defined. This study aimed to comprehensively characterize the spatial distribution patterns and prognostic relevance of TLS subtypes in patients with pMMR RC. Methods: We retrospectively analysed tissue sections from 155 patients with pMMR RC who underwent radical resection. TLS maturation subtypes were identified by using hematoxylin and eosin staining and immunohistochemistry, with their spatial distribution quantified and associated with prognosis. Results: The number of all TLS maturation subtypes in the invasive margin was significantly higher than that in the central tumor region (invasive margin vs central tumor region, Conclusion: Secondary follicle-like TLS infiltration independently predicts survival in pMMR RC, underscoring its potential as a prognostic biomarker and immunotherapeutic target.
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