Department of Pathology, Boston Medical Center, Boston, MA, USA.
Massachusetts General Hospital Cancer Center, Boston, MA, USA.
Br J Cancer. 2023 Oct;129(6):917-924. doi: 10.1038/s41416-023-02372-1. Epub 2023 Jul 28.
Lymph node (LN) harvesting is associated with outcomes in colonic cancer. We sought to interrogate whether a distinctive immune milieu of the primary tumour is associated with LN yield.
A total of 926 treatment-naive patients with colorectal adenocarcinoma with more than 12 LNs (LN-high) were compared with patients with 12 or fewer LNs (LN-low). We performed immunohistochemistry and quantification on tissue microarrays for HLA class I/II proteins, beta-2-microglobulin (B2MG), CD8, CD163, LAG3, PD-L1, FoxP3, and BRAF V600E.
The LN-high group was comprised of younger patients, longer resections, larger tumours, right-sided location, and tumours with deficient mismatch repair (dMMR). The tumour microenvironment showed higher CD8+ cells infiltration and B2MG expression on tumour cells in the LN-high group compared to the LN-low group. The estimated mean disease-specific survival was higher in the LN-high group than LN-low group. On multivariate analysis for prognosis, LN yield, CD8+ cells, extramural venous invasion, perineural invasion, and AJCC stage were independent prognostic factors.
Our findings corroborate that higher LN yield is associated with a survival benefit. LN yield is associated with an immune high microenvironment, suggesting that tumour immune milieu influences the LN yield.
淋巴结（LN）清扫与结直肠癌患者的预后相关。我们试图探究原发肿瘤中独特的免疫微环境是否与 LN 产量有关。
共比较了 926 例初治、有 12 个以上 LN（LN-高）的结直肠腺癌患者与有 12 个或更少 LN（LN-低）的患者。我们对组织微阵列进行了 HLA Ⅰ/Ⅱ类蛋白、β2-微球蛋白（B2MG）、CD8、CD163、LAG3、PD-L1、FoxP3 和 BRAF V600E 的免疫组化和定量分析。
LN-高组患者年龄较小，手术切除范围较长，肿瘤较大，位于右侧，且存在错配修复缺陷（dMMR）。与 LN-低组相比，LN-高组肿瘤中 CD8+细胞浸润和肿瘤细胞上 B2MG 表达更高。LN-高组的估计疾病特异性生存率高于 LN-低组。多因素预后分析中，LN 产量、CD8+细胞、外膜静脉侵犯、神经周围侵犯和 AJCC 分期是独立的预后因素。
我们的研究结果证实，较高的 LN 产量与生存获益相关。LN 产量与免疫高微环境相关，提示肿瘤免疫微环境影响 LN 产量。
