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Tertiary lymphoid structures in colorectal cancer
Jianyu Lv1, Xiuyu Zhang1, Mi Zhou1
1Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang Chinese Medical University, Zhejiang, China.
Annals of Medicine
|November 22, 2024
Summary
Tertiary lymphoid structures (TLS) in colorectal cancer (CRC) are immune cell clusters linked to better patient outcomes. Understanding TLS formation and function may improve CRC prognosis and treatment strategies.
Area of Science:
- Immunology
- Oncology
- Pathology
Background:
- Tertiary lymphoid structures (TLS) are immune cell aggregations in non-lymphoid tissues, notably the tumor microenvironment (TME).
- TLS resemble secondary lymphoid organs and are found in various solid tumors, including colorectal cancer (CRC).
- Their presence in CRC is associated with a favorable prognosis, prompting research into their role in immune modulation and cancer outcomes.
Purpose of the Study:
- To review the current knowledge on TLS in CRC, covering their formation, function, and prognostic significance.
- To explore how TLS influence the immune response within the TME and their correlation with CRC patient outcomes.
- To discuss TLS as potential therapeutic targets for enhancing anti-tumor immunity.
Main Methods:
- A comprehensive review of recent studies on TLS in CRC.
- Inclusion of data from histopathological analyses, immunohistochemistry, and clinical trials.
- Examination of the association between TLS characteristics (density, composition) and CRC prognosis, alongside emerging therapeutic strategies.
Main Results:
- TLS presence in CRC generally correlates with improved prognosis, especially in early stages.
- TLS formation involves immune cell organization (B/T zones, HEVs, FDCs) driven by inflammation.
- Higher TLS density and maturity are linked to reduced recurrence and increased survival, with potential interplay with immune checkpoint inhibitors.
Conclusions:
- TLS are significant prognostic markers in CRC, associated with favorable clinical outcomes.
- Further research is needed to elucidate TLS mechanisms in the TME and develop targeted therapies.
- Integrating TLS-focused strategies into CRC treatment may enhance patient management and outcomes.
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