Yang Xin, Wu Xiangyu, Hao Xuyang, Li Tianhang, Guo Hongqian, Yang Rong
Department of Urology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Department of Urology, Zhongda Hospital, Southeast University, Nanjing, China.
J Transl Med. 2025 Apr 29;23(1):489. doi: 10.1186/s12967-024-05864-7.
Tumor-draining lymph nodes (TDLNs) are often involved during the metastasis of bladder cancer (BC), which is associated with a poor prognosis. Recent studies have shown that TDLNs are a major source of host anti-tumor immunity, which can impede tumor progression and favor tumor immunotherapy. However, during tumor progression, various tumor-derived mediators modulate the TDLN microenvironment, impairing their protective function. Ultimately, TDLNs provide the soil for the proliferation and dissemination of tumor cells. Therefore, surgical removal of TDLNs is commonly recommended in various solid tumors to prevent metastasis, but this poses significant challenges for leveraging TDLNs in immunotherapy. Additionally, lymph node dissection (LND) has not shown survival benefits in some tumors. Hence, the decision to remove TDLNs in oncological treatment needs to be reconsidered. Herein, we spotlight the TDLNs of BC and introduce how BC cells modulate stromal cells and immune cells to shape an immunosuppressive TDLN microenvironment for BC progression. We summarize the existing therapeutic strategies to reinvigorate anti-tumor immunity in TDLNs. Furthermore, we discuss whether to preserve TDLNs and the role of LND during oncological treatment.
肿瘤引流淋巴结（TDLNs）在膀胱癌（BC）转移过程中常被累及，这与预后不良相关。最近的研究表明，TDLNs是宿主抗肿瘤免疫的主要来源，可阻碍肿瘤进展并有利于肿瘤免疫治疗。然而，在肿瘤进展过程中，各种肿瘤衍生介质会调节TDLN微环境，损害其保护功能。最终，TDLNs为肿瘤细胞的增殖和扩散提供了土壤。因此，在各种实体瘤中通常建议手术切除TDLNs以预防转移，但这对在免疫治疗中利用TDLNs构成了重大挑战。此外，淋巴结清扫（LND）在某些肿瘤中并未显示出生存获益。因此，在肿瘤治疗中切除TDLNs的决定需要重新考虑。在此，我们聚焦于BC的TDLNs，并介绍BC细胞如何调节基质细胞和免疫细胞，以形成有利于BC进展的免疫抑制性TDLN微环境。我们总结了现有的恢复TDLNs抗肿瘤免疫的治疗策略。此外，我们讨论了在肿瘤治疗期间是否保留TDLNs以及LND的作用。
