Tertiary lymphoid structures are associated with lower axillary residual nodal burden in breast cancer patients after neoadjuvant chemotherapy

作者：Zhihao Wei, Konglan Lin, Wu Deng, Yuanle Chen, Yiwen Lu · 发表于：European journal of medical research · 年份：2025 · DOI：10.1186/s40001-025-03556-6 · 被引用次数：2 · 研究领域：Lymphatic System and Diseases、Breast Cancer Treatment Studies、Lymphatic Disorders and Treatments

BACKGROUND: Tertiary lymphoid structures (TLSs) are associated with an improved chemotherapy response and favorable clinical outcomes in various tumor types, including breast cancer. The number of TLSs increases in breast cancer after neoadjuvant chemotherapy (NAC), potentially activating the immune landscape of the tumor microenvironment. However, the potential relationship between TLSs and clinicopathological characteristics in patients with breast cancer after receiving NAC is poorly understood. METHODS: This retrospective study included clinicopathological data from breast cancer patients treated at Sun Yat-Sen Memorial Hospital between 2012 and 2023. Hematoxylin‒eosin staining and immunohistochemical analysis were performed to evaluate TLSs and lymphatic vessels in two cohorts comprising 326 NAC-treated and 304 treatment-naive breast cancer patients, with validation conducted in a cohort of 23 paired biopsy specimens collected before and after receiving NAC. RNA fluorescence in situ hybridization (RNA-FISH) was employed to quantify lymphatic endothelial cell patterns. TLS gene expression scores were determined to validate the observed differences in TLS patterns in breast cancer patients. RESULTS: TLSs were more common in breast cancer samples after receiving NAC (p < 0.0001). Compared with breast cancer patients with a low density of TLSs (TLS-low) (n = 92) and with the absence of TLSs (TLS-absent) (n = 142), patients with a high density of TLSs (TLS-high) (n = 92) exhi...