## 3 Results
### CD8+ T-Cells in Tumor Microenvironment Predict Inferor MCL Survival  
The tumor microenvironmental immunocyte composition of MCL cases was predicted using the CIBERSORTx program (Figure S4). To address whether there is any relationship between immunocytes infiltrating the tumor microenvironment and the overall survival of MCL patients, we divided all 31 patients or 27 diagnostic patients into two groups based on the presence of each immunocyte whose abundance in TME was predicted by the CIBERSORTx program. These analyses showed that MCL cases with a high proportion of CD8+T-cells have significantly poorer overall survival in all (Figure 10A) or diagnostic cases (Figure 10B). Resting NK-cell abundance in TME was associated with poor overall  
Figure 9: Top overexpressed transcripts significantly associated with MCL overall survival. MCL cases were dichotomized based on the mRNA or lncRNA expression levels of the top 10 cancerogenesis-related genes or the top 20 upregulated alternative transcripts. Kaplan–Meier curves of VWF mRNA (**A,B**), FTX lncRNA (**C,D**) and MSTRG.153013.3 alternative transcript (**E,F**) whose expression are significantly associated with poor or good overall survival in all (**A,C,E**) or diagnostic cases (**B,D,F**). \(p<0.05\) is considered statistically significant. High: High transcript expression. Low: Low transcript expression.  
survival (Figure 10C), whereas eosinophils were associated with good survival (Figure 10D), in diagnostic MCL cases. No significant relationship with MCL survival was detected for all the other immunocytes evaluated. Tumor-infiltrating immune-cell abundances estimated with CIBERSORTx were cross-validated, either with immunohistochemistry (CD8\({}^{+}\) T or NK cells) or with hematoxylin-eosin staining (eosinophils) in MCL cases representing high or low ratios of these cell types (Figure S5).  
Impact of Tumor-infiltrating CD8\({}^{+}\) T-Cell Abundance and Cancer-Associated Transcripts on MCL Survival  
As CD8\({}^{+}\) T-cell abundance predicted inferior overall survival in all, as well as diagnostic, MCL cases, we performed MCL survival analysis by co-analyzing CD8\({}^{+}\) T-cell ratios together with the top 10 cancer-associated, upregulated mRNAs or lncRNAs to evaluate the possibility of identifying high-risk MCL cases. When tumor-infiltrating CD8\({}^{+}\) T-cell abundance was analyzed together with each of these transcripts, we observed that high CD8\({}^{+}\) T-cells with low expression levels of FTX lncRNA predicted poorer overall survival compared to CD8\({}^{+}\) T-cell ratio when all (Figure 11A) or diagnostic (Figure 11B) MCL cases were analyzed. Similar to these results, MCL cases with high CD8\({}^{+}\) T-cell ratios and low PCA3 lncRNA levels predicted poor survival more significantly than evaluating CD8\({}^{+}\) T-cells alone in all (Figure 11C) as well as diagnostic (Figure 11D) MCL cases. Of significance, MCL patients with a high ratio of CD8\({}^{+}\) T-cells and high expression of CCND1 constituted a high-risk group among diagnostic MCL cases (Figure S6).  
Figure 10: Microenvironmental immunocytes associated with overall survival of MCL patients. Kaplan-Meier plots show the tumor-infiltrating immunocytes that are associated with poor (**A–C**) or good (**D**) overall survival. High: High ratio of the immune cell. Low: Low ratio of the immune cell. All cases: 27 diagnostic and 4 relapsed MCL.