Classification of lymph node metastasis for NSCLC: New classification based on the number of metastatic lymph node comparing to the current classification based on its location

2008 ◽  
Vol 26 (15_suppl) ◽  
pp. 7535-7535
Author(s):  
H. Matsuguma ◽  
R. Nakahara ◽  
Y. Ishikawa ◽  
H. Suzuki ◽  
T. Kondo ◽  
...  
Author(s):  
Hang Du ◽  
Jingling Tang ◽  
Xiaoyun Li ◽  
Xinjun Wang ◽  
Liyun Wu ◽  
...  

Lymph node metastasis indicates a poor prognosis in colorectal cancer. To better understand the underlying mechanisms of lymph node metastasis, we analyzed transcriptome characteristics of the pre-metastatic lymph node, a putative microenvironment favorable for the seeding and proliferation of cancer cells. Thus, we tried to compare and elucidate the transcriptional and immune characteristics of sentinel lymph nodes (SNs) with matched non-sentinel lymph nodes (NSNs) in colorectal cancer patients. In this study, a total of 38 pairs of SNs and NSNs were collected, in which 26 pairs of non-metastatic lymph nodes were subjected to RNA-seq and bioinformatics analysis for the gene expression profiles. There were 16 differentially expressed genes between SNs and NSNs being identified, including 9 upregulated and 7 downregulated genes in SN. Gene Ontology (GO) classification analysis revealed that the differentially expressed genes were mainly involved in leukocyte differentiation, chemokine secretion, and immune system regulation. In the meantime, gene set enrichment analysis (GSEA) showed that immune-related signaling pathways, such as transforming growth factor beta (TGF-β) signaling and tumor necrosis factor alpha (TNF-α)/nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling, were enriched in NSN, while cell proliferation–related signaling pathways were enriched in SN, including MYC signaling and G2M checkpoint signaling. We further identified SIGLEC15 as a top upregulated gene in SN. However, RNAscope assay showed that SIGLEC15 was not largely co-expressed with M2 macrophage marker CD163. We then selected eight pairs of lymph nodes for further cytological studies. Flow cytometry analysis revealed that Siglec-15 was expressed on all myeloid cell subsets. The relative expression of SEGLEC15 (SN/NSN) was correlated with the microsatellite instability (MSI) status in colorectal cancer patients. Further studies found that small interfering ribonucleic acid (siRNA)-mediated silencing of SLGLEC15 can enhance the anti-tumor function of T cells, as indicated by cytokine release analysis. In conclusion, we presented here a first report on the gene expression profiling of the pre-metastatic lymph node in colorectal cancer. The findings in this study suggest that SIGLEC15 plays an important role in SN immunosuppression. SEGLEC15 silencing could be a therapeutic strategy for restoring T cell function in tumor SNs.


2021 ◽  
Author(s):  
Yanlei Chen ◽  
Chunyu Yang ◽  
Yue Wang ◽  
Xueqian Ma ◽  
Yanping Wang ◽  
...  

Abstract BackgroundColorectal cancer (CRC) is among the most common malignancies worldwide. M2 macrophages and regulatory T cells (Tregs) are immunosuppressive cells that can promote tumor progression via inhibiting anti-tumor immunities. However, the significance and correlation of the two types of cells in colorectal cancer are still inconclusive. The purpose of this study is to detect the number of M2 macrophages and Tregs in colorectal cancer and lymph nodes and to explore the clinical and pathological significance of their existence.MethodsThe pathologic specimens and clinical data of 197 patients with Colorectal cancer after radical resection were collected. Immunohistochemical methods were used to detect the expression of M2 macrophages and Tregs in colorectal cancer tissues, adjacent tissues, and lymph node tissues in each group.ResultsCompared with adjacent tissues and non-metastatic lymph node tissues, M2 macrophages and Tregs not only increased significantly in cancer tissues and metastatic lymph node tissues (P < 0.001), but also M2 macrophages in non-metastatic lymph node tissues adjacent to cancer tissues the number of phages expressed also increased significantly (P < 0.05). In addition, there was a positive correlation between the number of cancer tissues and lymph nodes (P < 0.001).ConclusionM2 macrophages are involved in the formation of lymph node immunosuppressive environment and promote the development of CRC and lymph node metastasis together with Tregs. Upregulation of M2 macrophages and Tregs expression is a prognostic marker for monitoring the condition of colorectal cancer and judging the prognosis.


2012 ◽  
Vol 147 (2_suppl) ◽  
pp. P166-P166
Author(s):  
Min-Seok Jang ◽  
Young-Ik Son ◽  
Jeong-Hwan Baek ◽  
Ki-Nam Park ◽  
Dohun Kim

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5587-5587
Author(s):  
J. Park ◽  
S. Seo ◽  
S. Kang ◽  
S. Lim ◽  
M. Lim ◽  
...  

5587 Background: Previosly, we reported the accuracy of positron emission tomography with 2-[fluorine18] fluoro-2-deoxy-D- glucose (FDG-PET) for detecting metastatic lymph node (LN) in cervical cancer (Eur J Cancer 2005: 41; 2086–92). The aim of this prospective study was to evaluate the accuracy of PET/CT for detecting lymph node metastasis in cervical cancer and to compare the accuracy between PET and PET/CT. Methods: From May 2002 to Jul 2006, 86 patients with untreated stage IB-IVA cervical cancer were enrolled. All patients underwent pretreatment clinical staging including PET (May 2002-Aug 2003, 54 patients) or PET/CT (Jan 2004-Jul 2006, 32 patients) followed by surgical staging including systematic pelvic and paraaortic lymph node (PLN and PALN) dissection. To enable region specific comparisons, PALN and PLN were divided into eight regions: both PALN, both common iliac areas, both external iliac areas, and both internal iliac/obturator areas. Each lymph node was sliced at 2-mm intervals perpendicular to the greatest dimension to maximize the likelihood of detecting micrometastases. All metastatic tumor size in each involved lymph node was measured. Histopathologic evaluation of lymph nodes was the diagnostic standard. The study protocol was approved by Institutioal Review Board, and a written informed consent was obtained. Results: A total of 688 LN regions were evaluated. The sensitivity, specificity, positive predictive value, and negative predictive value of PET and PET/CT are shown in Table 1 . As the metastatic tumor size increased, the sensitivity of PET and PET/CT was improved. Although there were no differences in sensitivity for detecting large sized (> 5mm or 10mm) metastatic tumor, PET/CT was more sensitive than PET for all pathologically proven LN metastasis which included small sized (< 5mm) metastatic tumor. Conclusions: PET/CT was more sensitive than PET for detecting small sized (<5mm) lymph node metastasis in cervical cancer. [Table: see text] No significant financial relationships to disclose.


2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 11-11
Author(s):  
Sung Min Jung ◽  
Dae Young Cheung ◽  
Jin Il Kim ◽  
Jae J. Kim ◽  
Sang Woo Lee ◽  
...  

11 Background: Stomach CT and endoscopic ultrasonography are used for evaluating pre-operative staging of gastric cancer. The aim of this study was to compare the pre-operative CT and endoscopic ultrasonographic staging to post-operative pathologic staging. Methods: We reviewed medical records of 567 patients with gastric cancer from 2012 to 2015, and compared their pre-operative CT staging to post-operative pathologic staging. Among the 567 patients, 149 patients underwent pre-operative endoscopic ultrasonographic staging, so we compared their pre-operative endoscopic ultrasonographic staging to post-operative pathologic staging. We also investigated lymph node metastasis in 146 patients with gastric cancer invading submucosa, planning to undergo endoscopic submucosal dissection. Results: The numbers of patients diagnosed as T1, T2, T3, T41, and T4b by pre-operative CT staging were 327, 97, 93, 46, and 4, respectively. However, the numbers of patients diagnosed as T1, T2, T3, T41, and T4b by post-operative pathologic staging were 208, 153, 53, 83, 62, and 8, resulting the pre-operative CT staging to be under-estimated. Similarly, pre-operative endoscopic ultrasonographic staging was also under-estimated, as although 48, 67, 32, and 2 patients were diagnosed as T1a, T1b, T2, and T3, respectively, by the pre-operative endoscopic ultrasonographic staging, post-operative pathologic staging revealed 72, 55, 13, 7, and 2 patients. In patients with gastric cancer invading submucosa (sm), there were 56 patients with sm1 invasion, 32 patients with sm2 invasion, and 91 patients with sm3 invasion. Lymph node metastasis was observed in 7 patients with sm1 invasion, 3 patients with sm2 invasion, and 22 patients with sm3 invasion. Poorly cohesive gastric cancer was the most common pathologic diagnosis in patients with metastatic lymph node. Conclusions: Physicians should keep in mind that pre-operative stomach CT and endoscopic ultrasonographic staging can be under-estimated compared to post-operative pathologic staging. Also, patients with poorly cohesive adenocarcinoma had more lymph node metastasis than patients with differentiated adenocarcinoma.


2020 ◽  
Author(s):  
Yanping Wang ◽  
Jikun Wang ◽  
Jinhao Liu ◽  
Zuoxiu Shi ◽  
Yanlei Chen ◽  
...  

Abstract Background: Lymph node metastasis is a major prognostic factor of colorectal cancer and an important indicator for individualized treatment. M2 macrophages play a key role in carcinogenesis and tumor development, not only enhancing invasiveness, but also promoting lymph node metastasis. The purpose of this study was to investigate the effect of CD163-positive M2 macrophages on lymph node metastasis in colorectal cancer.Methods: Postoperative lymph node tissues were obtained from 120 patients with colorectal cancer who underwent radical surgery in the First Affiliated Hospital of Jinzhou Medical University between December 2019 and May 2020. We detected the expression of the CD163 protein in lymph nodes by immunohistochemistry. Furthermore, the relationship between M2 macrophages identified by this marker and lymph node metastasis were analyzed using the independent sample T-test and Chi-square test.Results: M2 macrophages were increased not only in metastatic lymph nodes, but also in non-metastatic lymph nodes adjacent to the cancer. The M2 macrophage count was higher in patients with macro-metastases than in those with micro-metastases.Conclusions: M2 macrophages represent an important factor for the promotion of lymph node metastasis in colorectal cancer, and may be a potential marker for its prediction. This may offer a new target for the comprehensive treatment of colorectal cancer.


2020 ◽  
Author(s):  
Chaoyang Jiang ◽  
Ji Ma ◽  
Hui Gao ◽  
Ling Zhang ◽  
Hua Li ◽  
...  

Abstract Background:Lymph node metastasis in the cervical region posterior to level V (PLV) often occurs in patients with nasopharyngeal carcinoma (NPC), but the significance of lymph node metastasis in this region and the delineation of the radiotherapy target area have not been reported. We aimed to explore the distribution pattern and prognosis of metastatic lymph nodes in the PLV region in patients with NPC.Methods:We retrospectively studied 605 cases of NPC diagnosed by pathology from December 2011 to November 2017. All patients were subjected to an enhanced CT scan from the cranial apex to 2 cm below the sternoclavicular joints. The nodal distribution at each level was assessed in accordance with the Radiation Therapy Oncology Group (RTOG) guidelines proposed in 2013. The central points of the metastatic lymph nodes of the PLV region in the patients were recreated proportionally on the CT images of a standard patient with N0 NPC in reference to the normal anatomy of the PLV area. The correlation between the PLV region and the other levels, the nodal location, and the characteristics and prognosis of the PLV region were analyzed.Results:Lymph node metastasis occurred in 557 (92.06%) of 605 patients, and the top four areas with the highest probability of metastasis were level IIb (77.85%), level VIIa (73.05%), level IIa (60.0%), and level III (41.48%). There were 30 patients (4.95%) with lymph node metastasis in the PLV region. A total of 49 metastatic lymph nodes from the PLV region were counted, and the mean distance of the central point of each lymph node from the leading edge of the trapezius muscle was 14 mm. Linear regression correlation analysis suggested that lymph node metastasis in the PLV region was associated with ipsilateral level IVa (P=0.018), level Va, level Vb, and level Vc lymph node metastasis (all P<0.001). The 5-year OS, PFS, LRFS, and DMFS of 29 patients with lymph node metastasis in the PLV region were 41.6%, 27.7%, 89.1%, and 47.3%, respectively. The 5-year OS, PFS, LRFS, and DMFS of patients with N3 NPC with or without lymph node metastasis in the PLV region were 41.8% vs 67.3% (P=0.007), 27.8% vs 48.5% (P=0.005), 92.3% vs 80.5% (P=0.521), 40.6% vs 78.4% (P<0.001), respectively. Multivariate analysis showed that lymph node metastasis in the PLV region was an independent prognostic factor for DMFS (P<0.05).Conclusion:NPC patients with lymph node metastasis in the PLV region had a poor prognosis and a high risk of distant metastasis. When patients have lymph node metastasis in levels IVa and V, the posterior boundary of the radiotherapy target in ipsilateral level V should be appropriately moved backward. We recommend that the margin of the PLV region may be a new cervical lymph node segment for head and neck tumors.


Author(s):  
Jin Li ◽  
Peng Wang ◽  
Yang Zhou ◽  
Hong Liang ◽  
Kuan Luan

The classification of colorectal cancer (CRC) lymph node metastasis (LNM) is a vital clinical issue related to recurrence and design of treatment plans. However, it remains unclear which method is effective in automatically classifying CRC LNM. Hence, this study compared the performance of existing classification methods, i.e., machine learning, deep learning, and deep transfer learning, to identify the most effective method. A total of 3,364 samples (1,646 positive and 1,718 negative) from Harbin Medical University Cancer Hospital were collected. All patches were manually segmented by experienced radiologists, and the image size was based on the lesion to be intercepted. Two classes of global features and one class of local features were extracted from the patches. These features were used in eight machine learning algorithms, while the other models used raw data. Experiment results showed that deep transfer learning was the most effective method with an accuracy of 0.7583 and an area under the curve of 0.7941. Furthermore, to improve the interpretability of the results from the deep learning and deep transfer learning models, the classification heat-map features were used, which displayed the region of feature extraction by superposing with raw data. The research findings are expected to promote the use of effective methods in CRC LNM detection and hence facilitate the design of proper treatment plans.


Sign in / Sign up

Export Citation Format

Share Document