Predicting survival in oral squamous cell carcinoma via integrated analysis of tumor budding and tertiary lymphoid structures
By
Zhuqin Xiang
Yaqi Huang
Bokai Yun
Dongpeng Li
Fengshuo Liu
Junliang Liu
Nan Xie
Zehang Zhuang
Jinsong Hou
Cheng Wang
June 3, 2026
Objective: To validate the prognostic value of tumor budding (TB) and tertiary lymphoid structures (TLS) in oral squamous cell carcinoma (OSCC) and establish a TB-TLS interaction model for assessing the tumor microenvironment.
Key Findings: High-grade TB correlated with poor survival outcomes. High-maturation TLS indicated favorable survival outcomes. The TB/TLS index showed superior prognostic ability compared to single biomarkers. A nomogram incorporating the TB/TLS index demonstrated reliable predictive performance. Interpretation: The study validated the prognostic significance of TB and TLS in OSCC, with the TB/TLS index providing better discrimination in survival prediction.
Limitations: The study is retrospective and may have inherent biases. External validation showed moderate predictive performance despite baseline differences. Conclusion: The TB/TLS index is a promising prognostic factor for OSCC, enhancing survival prediction models.
