The prognostic significance of tertiary lymphoid structures in oral squamous cell carcinomas: a systematic review.

IF 3.1 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Frontiers in oral health Pub Date : 2025-01-22 eCollection Date: 2024-01-01 DOI:10.3389/froh.2024.1524313

V Ribeiro, J-L Teillaud, M-C Dieu-Nosjean, G Lescaille, J Rochefort

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Abstract

Introduction: Upper aerodigestive tract cancers are prevalent, with a global incidence surpassing 500,000 new cases in 2018. Among these, oral squamous cell carcinomas (OSCC) constitute the majority. OSCC has a low 5-year survival rate due to late-stage diagnosis. Risk factors include alcohol and tobacco use. However, non-smokers and non-drinkers are also affected, especially young patients with tongue cancer. The impact of tumor microenvironment (TME) and tumor-infiltrating lymphocytes (TILs) on OSCC prognosis remains debated. Remarkably, Tertiary Lymphoid Structures (TLS) identified in solid tumors have shown associations with favorable outcomes, yet their prognostic significance in OSCC remains understudied.

Objective: Thus, this systematic review aims to explore the value of TLS in OSCC reported in the literature.

Method: A scoping review was conducted and six retrospective cohort studies involving 1,203 patients met the inclusion criteria.

Results: Predominantly male patients, with an average age of 49.3 years were included. Immunohistochemistry was the primary method to identify TLS, present in 21% up to 100% of cases. TLS were predominantly located in the peri-tumoral area (75.4%-84.8%) compared to the intra-tumoral area (33.8%-33.9%). Our review shows that the presence of TLS is associated with improved survival in OSCC.

Discussion: However, variations in TLS detection and classification methods across studies introduce potential biases, hindering direct comparisons between findings. For instance, reports that are based solely on examining HES-stained slides for TLS identification may raise reliability concerns. Standardization of methodologies is imperative to ensure consistency in criteria utilization, thereby facilitating meaningful data comparisons.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023428010, PROSPERO (CRD42023428010).

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口腔鳞状细胞癌三级淋巴结构的预后意义：一项系统综述。

导读：上气消化道癌症很普遍，2018年全球新发病例超过50万例。其中，口腔鳞状细胞癌（OSCC）占多数。由于诊断较晚，OSCC的5年生存率较低。危险因素包括酒精和烟草的使用。然而，不吸烟者和不饮酒者也会受到影响，尤其是年轻的舌癌患者。肿瘤微环境（TME）和肿瘤浸润淋巴细胞（TILs）对OSCC预后的影响仍有争议。值得注意的是，在实体瘤中发现的三级淋巴结构（TLS）与良好的预后相关，但其在OSCC中的预后意义仍未得到充分研究。目的：因此，本系统综述旨在探讨TLS在文献报道的OSCC中的价值。方法：进行了一项范围综述，6项回顾性队列研究涉及1203例患者符合纳入标准。结果：患者以男性为主，平均年龄49.3岁。免疫组织化学是鉴别TLS的主要方法，出现在21%至100%的病例中。TLS主要位于肿瘤周围（75.4% ~ 84.8%），而肿瘤内（33.8% ~ 33.9%）。我们的综述显示，TLS的存在与OSCC中生存率的提高有关。讨论：然而，不同研究之间TLS检测和分类方法的差异引入了潜在的偏差，阻碍了研究结果之间的直接比较。例如，仅基于检查hes染色玻片进行TLS识别的报告可能会引起可靠性问题。方法的标准化是必要的，以确保标准使用的一致性，从而促进有意义的数据比较。系统评价注册：https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023428010, PROSPERO （CRD42023428010）。

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