The Progress of Tertiary Lymphoid Structures in Gastric Cancer

BACKGROUND: Tertiary lymphoid structures (TLSs), also known as ectopic lymphoid aggregates, have been increasingly recognized as important components of the tumor microenvironment. In gastric cancer, the presence, composition, size, density, and maturity of TLSs may significantly influence treatment response and patient prognosis. OBJECTIVE: This review aims to summarize the formation of TLSs and evaluate their potential roles as prognostic biomarkers and therapeutic targets in gastric cancer. METHODS: A comprehensive review of current literature was conducted to analyze the biological characteristics, formation mechanisms, and clinical relevance of TLSs in gastric cancer. RESULTS: Evidence suggests that TLSs are closely associated with improved immune responses, better therapeutic outcomes, and favorable prognosis in gastric cancer. Their structural features and maturation status may further modulate their functional roles in antitumor immunity. CONCLUSION: TLSs represent promising prognostic indicators and potential targets for immunotherapy in gastric cancer. However, several challenges remain, and further research is needed to better understand their mechanisms and clinical applications, ultimately contributing to improved survival and quality of life in patients with advanced gastric cancer.