Tertiary lymphoid structures in nasopharyngeal carcinoma: A multi-institutional study

Alhadi Almangush; Miia Ruuskanen; Jaana Hagström; Veli-Matti Kosma; Antti A Mäkitie; Ilmo Leivo

doi:10.1016/j.prp.2024.155789

Tertiary lymphoid structures in nasopharyngeal carcinoma: A multi-institutional study

Pathol Res Pract. 2024 Dec 22:266:155789. doi: 10.1016/j.prp.2024.155789. Online ahead of print.

Authors

Alhadi Almangush¹, Miia Ruuskanen², Jaana Hagström³, Veli-Matti Kosma⁴, Antti A Mäkitie⁵, Ilmo Leivo⁶

Affiliations

¹ Department of Pathology, University of Helsinki, P.O. Box 21, Helsinki FI-00014, Finland; Institute of Biomedicine, Pathology, University of Turku, Turku, Finland; Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland; Faculty of Dentistry, Misurata University, Misurata, Libya. Electronic address: alhadi.almangush@helsinki.fi.
² Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital and University of Turku, P.O. Box 52, Turku 20521, Finland.
³ Department of Pathology, University of Helsinki, P.O. Box 21, Helsinki FI-00014, Finland; Department of Oral Pathology and Radiology, University of Turku, Turku, Finland; Research Programs Unit, Translational Cancer Medicine, University of Helsinki, Helsinki, Finland.
⁴ School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, and Cancer Center of Eastern Finland, University of Eastern Finland, P.O. Box 1627, Kuopio, Finland; Biobank of Eastern Finland, Kuopio University Hospital, P.O. Box 100, Kuopio, Finland.
⁵ Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland; Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 263, Helsinki FI-00029, Finland; Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
⁶ Institute of Biomedicine, Pathology, University of Turku and Turku University Central Hospital, Kiinamyllynkatu 10 D 5035, Turku 20520, Finland.

PMID: 39724852
DOI: 10.1016/j.prp.2024.155789

Abstract

Background: Tertiary lymphoid structures (TLSs) associate with prognosis of many malignancies. However, the clinical significance of TLSs is not well-elucidated in nasopharyngeal carcinoma (NPC) patients.

Material and methods: In this whole population-based multicenter study, a total of 115 patients treated for NPC were included. The patients were treated at the five Finnish university hospitals. TLSs were assessed in routine hematoxylin and eosin (HE)-stained sections.

Results: Presence of TLSs associates significantly with improved survival in NPC. Absence of TLSs had a significant association with a poor disease-specific survival of NPC with a hazard ratio (HR) of 1.96 (95 % CI 1.09-3.53, P = 0.025) in the multivariable analysis. Similarly, absence of TLSs associated with worse overall survival with a HR of 1.68 (95 % CI 1.02-2.75, P = 0.040).

Conclusion: TLSs seem to be associated with prognosis of NPC patients. Having TLSs in NPC tumors correlates with good survival. The assessment of TLSs could aid in understanding the clinical behavior and in planning the treatment of NPC.

Keywords: Nasopharyngeal carcinoma (NPC); Prognosis; Tertiary lymphoid structures (TLSs).