胸腺上皮肿瘤（TET）是罕见的恶性肿瘤，缺乏确定的新辅助治疗生物标志物。本研究旨在评估人工智能（AI）驱动的肿瘤浸润淋巴细胞（TIL）分析在TET中的临床实用性。将在2004年1月至2021年12月期间首次诊断为不能手术切除的胸腺瘤或胸腺癌并接受新辅助治疗的患者纳入我们的研究人群。使用AI驱动的空间TIL分析仪对初次活检和手术的血红素和噻唑淋巴结染色切片进行分析。计量与免疫表型（IP）有关的肿瘤内TIL（iTIL）和间质TIL（sTIL）。本研究纳入了35名患者。在预新辅助活检中，无沙漠IP组患者的新辅助治疗部分反应比例较高（63.6％对17.6％，p = 0.038）。新辅助治疗后，iTIL（中位数22.18 / mm2对340.69 / mm2 p <0.001）和sTIL（中位数175.19 / mm2对531.02 / mm2 p = 0.004）显著增加。具有较高iTIL（> 147 / mm2）的患者展现出较长的无病生存期（中位数，29个月对12个月，p = 0.009）和总生存期（OS）（中位数，62个月对45个月，p = 0.002）。具有较高sTIL（> 232.1 / mm2）的患者表现出较长的OS（中位数62个月对30个月，p = 0.021）。初次活检中的无沙漠IP与新辅助治疗反应较好相关。手术标本中的更高iTIL和sTIL浸润与接受切除后新辅助治疗的TET患者的较长OS相关。 © 2023 The Authors. 由中国肺癌学会和约翰威利澳大利亚有限公司出版的《胸科肿瘤》。

Thymic epithelial tumors (TET) are rare malignancies and lack well-defined biomarkers for neoadjuvant therapy. This study aimed to evaluate the clinical utility of artificial intelligence (AI)-powered tumor-infiltrating lymphocyte (TIL) analysis in TET.Patients initially diagnosed with unresectable thymoma or thymic carcinoma who underwent neoadjuvant therapy between January 2004 and December 2021 formed our study population. Hematoxylin and eosin-stained sections from the initial biopsy and surgery were analyzed using an AI-powered spatial TIL analyzer. Intratumoral TIL (iTIL) and stromal TIL (sTIL) were quantified and their immune phenotype (IP) was identified.Thirty-five patients were included in this study. The proportion of patients with partial response to neoadjuvant therapy was higher in the group with nondesert IP in preneoadjuvant biopsy (63.6% vs. 17.6%, p = 0.038). A significant increase in both iTIL (median 22.18/mm2 vs. 340.69/mm2 , p < 0.001) and sTIL (median 175.19/mm2 vs. 531.02/mm2 , p = 0.004) was observed after neoadjuvant therapy. Patients with higher iTIL (>147/mm2 ) exhibited longer disease-free survival (median, 29 months vs. 12 months, p = 0.009) and overall survival (OS) (median, 62 months vs. 45 months, p = 0.002). Patients with higher sTIL (>232.1/mm2 ) exhibited longer OS (median 62 months vs. 30 months, p = 0.021).Nondesert IP in initial biopsy was associated with a better response to neoadjuvant therapy. Increased infiltration of both iTIL and sTIL in surgical specimens were associated with longer OS in patients with TET who underwent resection followed by neoadjuvant therapy.© 2023 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.