An IHC-derived TLS–CD8–macrophage immune niche score predicts major pathological response to neoadjuvant chemoimmunotherapy in resectable NSCLC

Background Neoadjuvant chemoimmunotherapy improves pathological response in resectable non-small cell lung cancer (NSCLC), but response remains heterogeneous. PD-L1 tumor proportion score (TPS) incompletely captures spatial immune contexture. We developed and cross-center validated an immunohistochemistry (IHC)-derived equal-weight immune niche score integrating tertiary lymphoid structure (TLS) maturity, CD8–TLS proximity, CD8/FOXP3 balance, CD163/CD68 ratio, and PD-L1 TPS. Methods This two-cen