Department of Pathology, Seoul National University Hospital, 28 Yeongon-dong, Jongno-gu, Seoul 110-744, Korea.
Br J Cancer. 2011 Jul 26;105(3):413-9. doi: 10.1038/bjc.2011.248. Epub 2011 Jul 5.
We aimed to evaluate the immunologic nature of sentinel lymph nodes (SLNs) in gastric cancer patients and to determine whether it can predict non-SLN metastasis.
Sentinel lymph node samples were collected from 64 gastric carcinoma patients who had undergone gastrectomy with SLN biopsy. One representative SLN sample was selected from each patient and was subjected to immunostaining for CD8, CD57, FOXP3, and DC-LAMP. The numbers of marker-positive cells in each sample were counted. The relationships between various immune cell densities and clinicopathologic parameters or metastasis status of SLNs and non-SLNs were sought.
High FOXP3+ Treg density of the SLN was found to be significantly associated with the presence of metastasis in either SLNs or non-SLNs. DC-LAMP+ cell density of the SLN was the highest at the isolated tumours cell level, and this decreased along with an increase in tumour metastasis in either SLNs or non-SLNs. Univariate and multivariate logistic regression models revealed that high FOXP3+ Treg density of the SLN was an independently significant predictor of non-SLN metastasis.
This study is the first to indicate an important role of SLNs in metastatic dissemination of gastric cancer. Our findings suggest that Tregs could be a new therapeutic target for regulating the metastasis of gastric cancer.
本研究旨在评估胃癌患者前哨淋巴结（SLN）的免疫学特性，并确定其是否可以预测非 SLN 转移。
对 64 例行胃癌根治术和 SLN 活检的胃癌患者采集 SLN 样本。对每个患者的一个代表性 SLN 样本进行 CD8、CD57、FOXP3 和 DC-LAMP 的免疫染色。计数每个样本中标记阳性细胞的数量。寻找各种免疫细胞密度与 SLN 和非 SLN 的临床病理参数或转移状态之间的关系。
发现 SLN 中高 FOXP3+Treg 密度与 SLN 或非 SLN 中的转移存在显著相关。SLN 的 DC-LAMP+细胞密度在孤立肿瘤细胞水平最高，随着 SLN 或非 SLN 中肿瘤转移的增加而降低。单因素和多因素逻辑回归模型表明，SLN 中高 FOXP3+Treg 密度是非 SLN 转移的独立显著预测因子。
这项研究首次表明 SLN 在胃癌转移扩散中具有重要作用。我们的研究结果表明，Tregs 可能是调节胃癌转移的新的治疗靶点。
