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Cellular and Molecular Biology

Immune microenvironment and lymph node yield in colorectal cancer

British Journal of Cancer volume 129, pages 917–924 (2023)Cite this article

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Abstract

Background

Lymph node (LN) harvesting is associated with outcomes in colonic cancer. We sought to interrogate whether a distinctive immune milieu of the primary tumour is associated with LN yield.

Methods

A total of 926 treatment-naive patients with colorectal adenocarcinoma with more than 12 LNs (LN-high) were compared with patients with 12 or fewer LNs (LN-low). We performed immunohistochemistry and quantification on tissue microarrays for HLA class I/II proteins, beta-2-microglobulin (B2MG), CD8, CD163, LAG3, PD-L1, FoxP3, and BRAF V600E.

Results

The LN-high group was comprised of younger patients, longer resections, larger tumours, right-sided location, and tumours with deficient mismatch repair (dMMR). The tumour microenvironment showed higher CD8+ cells infiltration and B2MG expression on tumour cells in the LN-high group compared to the LN-low group. The estimated mean disease-specific survival was higher in the LN-high group than LN-low group. On multivariate analysis for prognosis, LN yield, CD8+ cells, extramural venous invasion, perineural invasion, and AJCC stage were independent prognostic factors.

Conclusion

Our findings corroborate that higher LN yield is associated with a survival benefit. LN yield is associated with an immune high microenvironment, suggesting that tumour immune milieu influences the LN yield.

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Fig. 1: Correlation between number of positive LN and LN yield.
Fig. 2: Comparison between immune-high and immune-low tumours.
Fig. 3: The disease-specific survival according to the LN positivity (Kaplan–Meier method).
Fig. 4: The disease-specific survival according to the stage and immune profile (Kaplan–Meier method).

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Data availability

The data that support the findings of this study are not openly available to maintain patient confidentiality, but de-identified data are available from the corresponding author upon reasonable request.

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Acknowledgements

VD is partially funded by NIH grant.

Author information

Author notes

  1. Azfar Neyaz

    Present address: Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA

  2. These authors contributed equally: Vikram Deshpande, Osman Yılmaz.

Authors and Affiliations

  1. Department of Pathology, Boston Medical Center, Boston, MA, USA

    Soo Hyun Lee

  2. Massachusetts General Hospital Cancer Center, Boston, MA, USA

    Amaya Pankaj & David Ting

  3. Department of Pathology, Massachusetts General Hospital, Boston, MA, USA

    Azfar Neyaz & Omer Yilmaz

  4. Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Yuho Ono, Vikram Deshpande & Osman Yılmaz

  5. Harvard Medical School, Boston, MA, USA

    Yuho Ono, David Ting, Deepa T. Patil, Omer Yilmaz, David Berger, Vikram Deshpande & Osman Yılmaz

  6. David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA

    Steffen Rickelt

  7. Department of Surgery, Massachusetts General Hospital, Boston, MA, USA

    Cristina Ferrone & David Berger

  8. Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA

    Deepa T. Patil

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Contributions

OY and VD performed study concept and design; AP, AN, YO, and SR performed development of methodology; CF, DT, DP, OY, and DB provided acquisition of data and revision of paper; SL, OY, and VD analysed and interpreted data; SL, OY, and VD performed writing the paper. All authors reviewed and approved the final paper.

Corresponding authors

Correspondence to Vikram Deshpande or Osman Yılmaz.

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The authors declare no competing interests.

Ethics approval and consent to participate

The analyses of the cohort were conducted in adherence of the Declaration of Helsinki. The study was approved by the hospital institutional review board (IRB; MGB no. 2017P61).

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Lee, S.H., Pankaj, A., Neyaz, A. et al. Immune microenvironment and lymph node yield in colorectal cancer. Br J Cancer 129, 917–924 (2023). https://doi.org/10.1038/s41416-023-02372-1

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