Construction of a Tertiary Lymphoid Structure Gene Signature in Gastric Cancer and Its Predictive Value for the Tumor Microenvironment and Immunotherapy

This study aimed to investigate the impact of tertiary-lymphoid-structure-related genes on the clinical prognosis and tumor immune environment of patients with gastric cancer. Using The Cancer Genome Atlas data, 23 differentially expressed genes associated with the tumor microenvironment were identified and used to develop a prognostic model. Univariate and multivariate Cox regression analyses were conducted to assess the prognostic value of the model. The results revealed that high-risk patients presented increased activity in hypoxia, angiogenesis, epithelial–mesenchymal transition, and transforming-growth-factor-beta-signaling-related pathways, whereas low-risk patients presented increased activity in CD4+ T-cell-infiltration-related pathways. High-risk patients had lower survival rates and a worse response to immunotherapy. This model serves as an independent predictor of the survival of gastric cancer patients and can aid in immunotherapy decision-making.