Junwei Wang, Xin Chen, Limei Guo, Fei Li, Siyi Lu, Yao Ma, Lin Hsinyi, Xiangchao Shi, Wei Fu, Xin Zhou
Department of General Surgery, Peking University Third Hospital, PR China; Peking university third hospital cancer center, PR China; Beijing Key Laboratory of Collaborative Innovation in Gastrointestinal Oncology, PR China.
Department of General Surgery, Peking University Third Hospital, PR China; Peking university third hospital cancer center, PR China.
Transl Oncol. 2025 Jun;56:102368. doi: 10.1016/j.tranon.2025.102368. Epub 2025 Apr 14.
INTRODUCTION: Benign lymph node enlargement (BLNE) is common in colorectal cancer; however, few studies have investigated its influence on prognosis, clinicopathological features, and pathogenesis. METHODS: A cohort study was conducted to analyze the clinicopathologic features and prognosis of colorectal cancer patients, categorized based on the presence or absence of BLNE. Given the correlation between lymph nodes and immune response, immunohistochemistry, transcriptome analysis, and exon sequencing were employed to further investigate the differences in the immune microenvironment of primary tumors. RESULTS: Overall, 630 AJCC stage I/II patients were included in the study, with 131 in the BLNE group and 499 in the Non-BLNE (NBLNE) group. Patients in the BLNE group were found to have a significantly better disease-free survival (DFS) (hazard ratio [HR] 0.44, P = 0.016) and overall survival (OS) (HR 0.46, P = 0.011) than those in the NBLNE group. Pathologically, compared with the NBLNE group, the BLNE group had more mature tertiary lymphoid structures (66.7 % vs. 36.5 %, P = 0.002) and higher immunoscores (18.8 % vs. 2.1 %, P = 0.004) in primary tumor tissue. Also, transcriptome analysis showed that, compared with NBLNE, the genes upregulated in BLNE were enriched in immune-related pathways, such as adaptive immune response and immuno-regulatory interactions. Whole-exon sequencing analysis revealed a higher tumor mutation burden (TMB) in the BLNE group [6.03 (5.59, 7.59) vs. 5.33 (4.62, 6.34), P = 0.025]. CONCLUSION: BLNE is positively associated with the prognosis of colorectal cancer, possibly because patients with BLNE have a stronger anti-tumor immune response.
引言:良性淋巴结肿大(BLNE)在结直肠癌中很常见;然而,很少有研究调查其对预后、临床病理特征和发病机制的影响。 方法:进行了一项队列研究,以分析根据是否存在BLNE分类的结直肠癌患者的临床病理特征和预后。鉴于淋巴结与免疫反应之间的相关性,采用免疫组织化学、转录组分析和外显子测序进一步研究原发性肿瘤免疫微环境的差异。 结果:总体而言,本研究纳入了630例美国癌症联合委员会(AJCC)I/II期患者,其中BLNE组131例,非BLNE(NBLNE)组499例。发现BLNE组患者的无病生存期(DFS)(风险比[HR]0.44,P = 0.016)和总生存期(OS)(HR 0.46,P = 0.011)明显优于NBLNE组。病理上,与NBLNE组相比,BLNE组原发性肿瘤组织中具有更成熟的三级淋巴结构(66.7%对36.5%,P = 0.002)和更高的免疫评分(18.8%对2.1%,P = 0.004)。此外,转录组分析表明,与NBLNE相比,BLNE中上调的基因富集于免疫相关途径,如适应性免疫反应和免疫调节相互作用。全外显子测序分析显示BLNE组的肿瘤突变负担(TMB)更高[6.03(5.59,7.59)对5.33(4.62,6.34),P = 0.025]。 结论:BLNE与结直肠癌的预后呈正相关,可能是因为BLNE患者具有更强的抗肿瘤免疫反应。
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