Abstract Background Due to the emergence of a vast amount of single-cell RNA sequencing (scRNA-seq) and single-cell resolution spatial transcriptomics (ST), there has been a demand for cell type annotation pipelines that are reproducible, scalable, and capable of functioning as end-to-end solutions. Reference-dependent cell typing may be compromised due to a labor-intensive preparation step for scRNA-seq data matching the data to be labeled and the algorithm. Also, reference-free pipelines couldn’t provide appropriate human-interpretable labels for each deconvoluted cell type, limiting their comparison with the existing literature. Furthermore, many algorithms often overlook the hierarchical structure of cell type annotations. Method We developed hierarchy-aware LLM-aided cell type annotator using cell type ontology tree. LLM can be any type, but we focused on gpt-4o and gpt-oss-20b. Step 1, we first excluded cell ontologies not relevant to the context, reducing ∼2,300 entries to about 400-500. Step 2, terms were processed in batches of 150 using the context and an LLM; the curated list was then reprocessed by the LLM, yielding fewer than 40 cell-type terms. Step 3, we elicited context-specific marker genes with the LLM in five independent runs and aggregated the results into a single list. Step 4, we clustered single cells using highly variable genes to obtain cluster labels, restricted the data to the Step 3 markers, and computed differentially expressed genes (DEGs). Using the top 20 DEGs for each cell, we queried the Step 2 term list to assign a cell-type label. We then retrieved the Cell Ontology tree and performed unsupervised hierarchical clustering on cluster centroids to infer relationships; aligning these with the ontology enabled hierarchical cell-type labeling for each cell. Results We applied the agentic workflow using LLM (gpt-oss-20b) to 40,000 lung cancer single-cell samples. A continuous hierarchy was reconstructed from “cell” (level 1) to T follicular helper cell (level 10). To assess performance, we compared Adjusted Rand Index (ARI) values between four ground-truth levels and the 10-level predicted hierarchy. We observed a maximum of 0.86 (Level 2 ground truth vs. Level 5 predicted label). Overall, the pipeline completed annotation efficiently, requiring approximately 40 minutes for ontology filtering and 20 minutes for all subsequent steps, demonstrating scalability for large-scale single-cell datasets. Conclusion Our pipeline provides scalable cell-type annotation to meet the recent surge of scRNA-seq data. Moreover, by leveraging the flexibility and memory capabilities of LLMs, it enables typing of minor cell types; by using existing cell-type ontology trees, it supports hierarchy-aware cell typing; and by constraining selections to the established cell ontology, it reduces hallucinations and yields human-interpretable cell typing. Citation Format: Jeongbin Park, Yuchang Seong, Hongyoon Choi, . Ontology-guided hierarchical cell typing with large language models for analyzing tumor microenvironment abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 2753.
Park et al. (Fri,) studied this question.