Tertiary lymphoid structures (TLS) are ectopic lymphoid structures in cancers that are largely associated with favourable prognosis. However, the prognostic value of TLSs in oral squamous cell carcinoma (OSCC) is largely unknown, and the association between tumour infiltrating lymphocytes (TILs) and TLSs has been rarely explored in OSCC. In this study, associated markers of TLS, including peripheral node address (PNAd) in high endothelial venules, CD20 in B cells and CD3 in T cells, were examined in 168 OSCC patients, and survival analysis was performed between TLS-positive and TLS-negative cohorts. We detected the presence of TILs by staining CD8+ cytotoxic T cells and CD57+ NK cells as well. TLSs appeared as highly organized structures in 45 (26.8%) cases. TLS-positive patients had a better 5-year overall survival (OS) rate (88.9% vs. 56.1%, P < 0.001) and relapse-free survival (RFS) rate (88.9% vs. 63.4%, P = 0.002). Moreover, the presence of TLS was an independent prognostic factor for both the 5-year OS rate (hazard ratio [HR] = 3.784; 95% confidence interval [CI], 1.498–9.562) and RFS rate (HR = 3.296; 95% CI, 1.279–8.490) in multivariate analysis. Furthermore, a higher density of CD8+ T cells and CD57+ NK cells was found in TLS-positive sections than in TLS-negative counterparts (P < 0.001), and their combination provided a higher predictive accuracy (AUC = 0.730; 95% CI, 0.654–0.805). In conclusion, our results suggest that TLS is an independent positive prognostic factor for OSCC patients. These findings provide a theoretical basis for the future diagnostic and therapeutic value of TLSs in OSCC treatment.

三级淋巴结构 (TLS) 是癌症中的异位淋巴结构，主要与良好的预后相关。然而，TLSs 在口腔鳞状细胞癌 (OSCC) 中的预后价值在很大程度上是未知的，肿瘤浸润淋巴细胞 (TILs) 与 TLSs 之间的关联在口腔鳞状细胞癌中很少被探索。在这项研究中，在 168 名 OSCC 患者中检查了 TLS 的相关标志物，包括高内皮小静脉中的外周淋巴结地址 (PNAd)、B 细胞中的 CD20 和 T 细胞中的 CD3，并在 TLS 阳性和 TLS- 之间进行了生存分析。负面的群体。我们还通过染色 CD8+ 细胞毒性 T 细胞和 CD57+ NK 细胞来检测 TIL 的存在。在 45 例 (26.8%) 案例中，TLS 表现为高度组织化的结构。TLS 阳性患者的 5 年总生存率 (OS) 更高（88.9% 对 56.1%，P  < 0.001) 和无复发生存 (RFS) 率 (88.9% vs. 63.4%, P  = 0.002)。此外，TLS 的存在是 5 年 OS 率（风险比 [HR] = 3.784；95% 置信区间 [CI]，1.498-9.562）和 RFS 率（HR = 3.296；95%）的独立预后因素CI，1.279–8.490）在多变量分析中。此外，在 TLS 阳性切片中发现的 CD8+ T 细胞和 CD57+ NK 细胞密度高于 TLS 阴性对应物（P < 0.001），它们的组合提供了更高的预测准确性（AUC = 0.730；95% CI，0.654–0.805）。总之，我们的结果表明，TLS 是 OSCC 患者的独立阳性预后因素。这些发现为 TLSs 在 OSCC 治疗中的未来诊断和治疗价值提供了理论基础。