Brief report: Lymph node morphology in stage II colorectal cancer

Abstract

Background Colorectal cancer is one of the leading causes of cancer-associated morbidity and mortality worldwide. The local anti-tumour immune response is particularly important for patients with stage II where the tumour-draining lymph nodes have not yet succumbed to tumour spread. The lymph nodes allow for the expansion and release of B cell compartments such as primary follicles and germinal centres. A variation in this anti-tumour immune response may influence the observed clinical heterogeneity in stage II patients. Aim The aim of this study was to explore tumour-draining lymph node histomorphological changes and tumour pathological risk factors including the immunomodulatory microRNA-21 (miR-21) in a small cohort of stage II CRC. Methods A total of 23 stage II colorectal cancer patients were included. Tumour and normal mucosa samples were analysed for miR-21 expression levels and B-cell compartments were quantified from Haematoxylin and Eosin slides of lymph nodes. These measures were compared to clinicopathological risk factors such as perforation, bowel obstruction, T4 stage and high-grade. Results We observed greater Follicle density in patients with a lower tumour T stage and higher germinal centre density in patients with higher pre-operative carcinoembryonic antigen levels. Trends were also detected between tumours with deficiency in mismatch repair proteins, lymphatic invasion and both the density and size of B-cell compartments. Lastly, elevated tumour miR-21 was associated with decreased Follicle and germinal centre size. Conclusion Variation in B-cell compartments of tumour-draining lymph nodes is associated with clinicopathological risk factors in stage II CRC patients.

The Risk Factors of Low Anterior Resection Syndrome After Colorectal Cancer Surgery Compared with the Last Decade Studies

“…tumor location, size, T stage and lymphatic nodal characteristics are directly related to surgical range and procedures; therefore, LARS is directly in uenced by these three factors [39][40][41]. But this theory is suggested in our study and the other studies have no mentioned the tumor T stage and nodal classi cation as the risk factors in their researches.…”

The risk factors of low anterior resection syndrome after colorectal cancer surgery: A retrospective study of 566 patients in a single institution in China

“…Tumor location, size, T stage and lymphatic nodal characteristics are directly related to surgical range and procedures; therefore, LARS is directly influenced by these three factors ( 39 – 41 ). But this theory is suggested in our study and the other studies have no mentioned the tumor T stage and nodal classification as the risk factors in their researches.…”

Mesenteric benign lymph node enlargement in colorectal cancer: Friend or Foe?

“…When the adaptive immune response begins, the contractile function of FRC actomyosin is inhibited, facilitating rapid lymph node expansion to accommodate the increased number of activated T and B cells [8]. Previous studies have also shown lymph node follicular hyperplasia in the drainage areas of patients with stage II colon cancer [9], suggesting an association between non-metastatic enlargement of tumordraining lymph nodes and the tumor-adaptive immune response. Recently, some studies have reported that BLNE is a favourable prognostic factor for colorectal cancer [7,10], while other studies have proposed hat it is associated with poorer prognosis [11].…”