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Intra-patient comparison of microarchitecture of tumour negative lymph nodes from oesophageal cancer patients -

Maximilian Kloft¹, Elzbieta Budginaite², Sander M J van Kuijk³

¹Department of Pathology, GROW - Research Institute for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, the Netherlands; Institute of Clinical Cancer Research, Krankenhaus Nordwest, Frankfurt, Germany.

Pathology, Research and Practice

|January 22, 2025

Summary

The immune response in tumour-negative lymph nodes (LNneg) of oesophageal cancer (OeC) patients is largely consistent. This finding supports using the largest LNneg to represent the overall anti-tumour immune response in OeC patients.

Keywords:

Immune biomarker Immune response Lymph nodes Microarchitecture Oesophageal cancer Surgical resection

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Area of Science:

Oncology
Immunology
Pathology

Background:

Regional lymph node (LN) status is a critical prognostic indicator in oesophageal cancer (OeC).
Tumour antigens can elicit immune responses in LNs, potentially reflecting the host's anti-tumour immunity.
It is not well understood if this immune response is uniform across all tumour-negative LNs (LNneg) within individual OeC patients.

Purpose of the Study:

To determine if the host anti-tumour immune response is similar in all LNneg from individual OeC patients, indicated by comparable microarchitectural features.
To assess if immune response measurements in the largest LNneg can reliably represent the immune status of all LNneg.

Main Methods:

Morphometric quantification of microarchitectural LN features (germinal centres (GermC), lymphocytes, histiocytes) in (y)pN0 OeC patients from the Oe02 trial with at least two LNneg.
Application of linear mixed-effects models, intraclass correlation coefficients (ICC), and Bland-Altman plots to evaluate systematic bias, reliability, and agreement of LNneg microarchitecture measurements.

Main Results:

No systematic bias was found in LNneg microarchitectural features within individual patients.
Moderate variability was observed for lymphocytes (ICC: 0.39) and GermC (ICC: 0.50).
High variability was noted for histiocytes (ICC: 0.07), with 5.0-8.5% of measurements falling outside 95% limits of agreement.

Conclusions:

This study is the first to systematically assess the agreement of microarchitectural features in LNneg within individual (y)pN0 OeC patients.
The absence of systematic bias supports the use of the largest LNneg as a surrogate for the patient's overall anti-tumour immune response.
Findings suggest that immune response assessment in a single, largest LNneg may be representative of the patient's systemic anti-tumour immunity.