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.
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.
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.
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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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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VD is partially funded by NIH grant.
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