A spatial immune scoring system based on the tumor microenvironment features improves prognostic stratification in lung adenocarcinoma

Cancer research · NSCLC

High Lung Cancer Immune Score (LCIS) independently predicts improved overall survival in lung adenocarcinoma.

The spatial heterogeneity of the tumor immune microenvironment in lung adenocarcinoma limits the prognostic accuracy of traditional TNM staging. Conventional T‑cell based immune scores developed for other solid tumors fail to effectively stratify patient outcomes in LUAD. We applied quantitative multiplex immunofluorescence to map the spatial immune contexture of LUAD and developed the Lung Cancer Immune Score (LCIS). LCIS integrates four biomarkers: CD68+HLA‑DR+ macrophages, CD20+ B cells, PD‑1+ cells and Ki67+ proliferating tumor cells, to quantify the balance between tumor proliferation and host anti‑tumor immunity across the tumor core and invasive margin. High LCIS scores independently predicted improved overall survival in both the discovery (p = 0.02) and independent validation (p = 0.017) cohorts, outperforming conventional clinical parameters and single biomarkers. LCIS sub‑stratifies Stage II and III LUAD into refined prognostic groups, resolving prognostic ambiguity within the same TNM stage. LCIS thus serves as a spatial biomarker to refine prognosis and inform personalized therapy in LUAD.

Demonstrated that a spatial tumor‑immune score surpasses TNM staging and single immune markers for prognostication, providing a clinically actionable tool for risk stratification and therapeutic decision‑making in LUAD patients.

Evidence level: Számítógépes vagy elméleti. Modellből vagy adatbányászatból származó jel.

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