%0 Journal Article
%T A Mature Tertiary Lymphoid Structure with a Ki-67-Positive Proliferating Germinal Center Is Associated with a Good Prognosis and High Intratumoral Immune Cell Infiltration in Advanced Colorectal Cancer.
%A Mori N
%A Dorjkhorloo G
%A Shiraishi T
%A Erkhem-Ochir B
%A Okami H
%A Yamaguchi A
%A Shioi I
%A Komine C
%A Endo M
%A Seki T
%A Hosoi N
%A Nakazawa N
%A Shibasaki Y
%A Okada T
%A Osone K
%A Sano A
%A Sakai M
%A Sohda M
%A Yokobori T
%A Shirabe K
%A Saeki H
%J Cancers (Basel)
%V 16
%N 15
%D 2024 Jul 28
%M 39123412
%F 6.575
%R 10.3390/cancers16152684
%X Tertiary lymphoid structures (TLSs) are complex lymphocyte clusters that arise in non-lymphoid tissues due to inflammation or cancer. A mature TLS with proliferating germinal centers is associated with a favorable prognosis in various cancers. However, the effect of TLS maturity on advanced colorectal cancer (CRC) remains unexplored. We analyzed the significance of TLS maturity and tumor Ki-67 expression in surgically resected tumors from 78 patients with pathological T4 CRC. Mature TLS was defined as the organized infiltration of T and B cells with Ki-67-positive proliferating germinal centers. We analyzed the relationship between TLS maturity and intratumoral immune cell infiltration. Mature TLS with germinal center Ki-67 expression was associated with microsatellite instability and improved survival; however, high tumor Ki-67 expression was associated with poor survival in the same cohort. Multivariate analysis identified the absence of mature TLS as an independent predictor of poor post-recurrence overall survival. Intratumoral infiltration of T lymphocytes and macrophages was significantly elevated in tumors with mature TLS compared to those lacking it. High Ki-67 levels and absent mature TLS were identified as poor prognostic factors in advanced CRC. Mature TLS could serve as a promising marker for patients at high-risk of CRC.