The spatial landscape of T cells in the microenvironment of stage III lung adenocarcinoma

Abstract This study aimed to provide more information for prognostic stratification for patients through an analysis of the T‐cell spatial landscape. It involved analyzing stained tissue sections of 80 patients with stage III lung adenocarcinoma (LUAD) using multiplex immunofluorescence and exploring the spatial landscape of T cells and their relationship with prognosis in the center of the tumor (CT) and invasive margin (IM). In this study, multivariate regression suggested that the relative clustering of CT CD4 + conventional T cell (Tconv) to inducible Treg (iTreg), natural regulatory T cell (nTreg) to Tconv, terminal CD8 + T cell (tCD8) to helper T cell (Th), and IM Treg to tCD8 and the relative dispersion of CT nTreg to iTreg, IM nTreg to nTreg were independent risk factors for DFS. Finally, we constructed a spatial immunological score named the G T score, which had stronger prognostic correlation than IMMUNOSCORE® based on CD3/CD8 cell densities. The spatial layout of T cells in the tumor microenvironment and the proposed G T score can reflect the prognosis of patients with stage III LUAD more effectively than T‐cell density. The exploration of the T‐cell spatial landscape may suggest potential cell–cell interactions and therapeutic targets and better guide clinical decision‐making. © 2024 The Pathological Society of Great Britain and Ireland.