第三类淋巴结构(TLSs)是非淋巴组织中的异位淋巴聚集体，与某些癌症类型的良好预后有关。本研究旨在调查TLS在食管癌(EC)中的临床意义。我们在两个不同机构的316个EC手术标本中评估了癌旁TLS的密度和成熟度，使用了苏木精/伊红染色、免疫组化和多重免疫荧光染色。我们分析了TLS与临床病理参数的关联。TLS的临床意义在34例接受抗PD-1抗体治疗的复发EC患者的不同队列中进一步评估。具有高TLS密度的肿瘤主要由成熟TLS组成。高TLS密度与较少晚期肿瘤阶段、无淋巴/血管侵犯、更好的血清营养参数(中性粒细胞计数、白蛋白、中性粒细胞/淋巴细胞比率和预后营养指数)以及延长的生存期显著相关。在成熟TLS病例中，这种生存趋势更为显著，代表了CD138+浆细胞的人口增加。在第二个EC队列中，TLS密度预测临床对抗PD-1抗体的反应和患者的生存率。癌旁TLS的密度和成熟度是预测EC患者长期生存和对抗PD-1抗体治疗反应的有用参数。© 2023年。 作者。

Tertiary lymphoid structures (TLSs) are ectopic lymphoid aggregates in non-lymphoid tissues, which are associated with improved prognosis in some cancer types. This study aimed to investigate the clinical significance of TLSs in oesophageal cancer (EC).In a series of 316 EC surgical specimens from two different institutes, we evaluated the density and maturity of peritumoral TLSs using haematoxylin/eosin, immunohistochemistry, and multiplex immunofluorescence staining. We analysed the association between TLSs and clinicopathological parameters. The clinical significance of TLSs was further evaluated in a different cohort of 34 patients with recurrent EC treated with anti-PD-1 antibody.Tumours with high TLS density predominantly consisted of matured TLSs. High TLS density was significantly associated with less advanced tumour stage, absence of lymphatic/vascular invasion, better serum nutrition parameters (neutrophils count, albumin, neutrophil-to-lymphocyte ratio, and prognostic nutritional index), and prolonged survival. This survival trend was more remarkable in cases with matured TLSs, which represented an increased population of CD138+ plasma cells. In the second EC cohort, TLS density predicted the clinical response to anti-PD-1 antibody and patient survival.The density and maturity of peritumoral TLSs are useful parameters for predicting long-term survival and response to anti-PD-1 antibody treatment in EC patients.© 2023. The Author(s).