Prognostic patterns in invasion lymph nodes of lung adenocarcinoma reveal distinct tumor microenvironments

Shen Lao ¹, Zisheng Chen ^1,2, Wei Wang ¹

⁰Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Healthy, Guangzhou, China.

Npj Precision Oncology +

|

July 30, 2024

View abstract on PubMed

Summary

Tumor-draining lymph nodes (TDLNs) in lung adenocarcinoma (LUAD) show distinct patterns linked to patient prognosis. Specific TDLN patterns, like scattered-type, are associated with higher recurrence risk and immune suppression.

Area Of Science

Oncology
Immunology
Pathology

Background

Tumor-draining lymph nodes (TDLNs) are critical sites for metastasis in lung cancer.
Lung adenocarcinoma (LUAD) patients with positive TDLNs (TDLNs+) exhibit diverse pathomorphologic and tumor microenvironment (TME) features.
Understanding these TDLN patterns is crucial for predicting LUAD patient outcomes.

Purpose Of The Study

To investigate the distinct pathomorphologic and TME-compositional patterns of TDLNs+ in LUAD.
To correlate these TDLN patterns with patient prognosis, specifically early recurrence risk.
To elucidate the immune hallmarks associated with different TDLN patterns in LUAD.

Main Methods

Analysis of 312 LUAD patients with TDLNs+ (2015-2019).
Digital scanning of TDLNs using 3DHISTECH.
Classification of TDLN patterns (polarized-type vs. scattered-type) and TME patterns (colloid-type, necrosis-type, specific-type, common-type).
Multivariate analysis for recurrence risk.
NanoString transcriptional analysis for immune hallmarks.
Imaging mass cytometry (IMC) for cellular and immune microenvironment assessment.

Main Results

Scattered-type, colloid-type, and necrosis-type TDLN patterns were associated with an increased risk of early recurrence.
NanoString analysis revealed immunosuppression and vascular invasion in scattered and necrosis patterns, versus immunoactivation in polarized and common patterns.
IMC showed compromised germinal centers, deficient T cell proliferation, and potentially weaker immune attack in scattered and necrosis patterns.

Conclusions

LUAD patients with TDLNs+ exhibit distinct patterns and immune hallmarks.
Specific TDLN patterns (scattered, colloid, necrosis) are significantly associated with higher early recurrence risk.
These findings highlight the prognostic value of TDLN morphology and TME composition in LUAD.

Related Concept Videos

The Tumor Microenvironment

Every normal cell or tissue is embedded in a complex local environment called stroma, consisting of different cell types, a basal membrane, and blood vessels. As normal cells mutate and develop into cancer cells, their local environment also changes to allow cancer progression. The tumor microenvironment (TME) consists of a complex cellular matrix of stromal cells and the developing tumor. The cross-talk between cancer cells and surrounding stromal cells is critical to disrupt normal tissue...

Metastasis

Metastasis is the spread of cancer cells from the original site to distant locations in the body. Cancer cells can spread via blood vessels (hematogenous) as well as lymph vessels in the body.
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...