PO.IM01.02 · 免疫学

衰老相关的区域淋巴结形态学改变促进结直肠癌免疫抑制性微环境

Aging-related morphological change in regional lymph nodes promotes an immunosuppressive microenvironment in colorectal cancer

编号 2898 展板 8 时间 4/20 02:00–05:00 区域 Section 10 主讲 Kosuke Kanemitsu, MD

分会场 Modifiers of Inflammation and the Tumor Microenvironment

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作者与单位 Authors & Affiliations

Kosuke Kanemitsu¹, Rin Yamada², Daiki Yoshii², Yukio Fujiwara², Yoshiyuki Tagayasu¹, Teruki Sako¹, Kota Arima¹, Kohei Yamashita¹, Kazuto Harada¹, Norihisa Hanada³, Yoshihiro Komohara², Masaaki Iwatsuki¹

¹Department of Gastroenterological Surgery, Kumamoto University Hospital, Kumamoto, Japan,²Department of Cell Pathology, Kumamoto University Hospital, Kumamoto, Japan,³Department of Surgery, Izumi General Medical Center, Kagoshima, Japan

摘要 Abstract

中文摘要

背景：淋巴结（LN）在抗癌免疫中发挥核心作用，然而衰老对癌症中淋巴结形态和功能的影响在很大程度上仍未被探索。本研究旨在阐明衰老相关的淋巴结改变与结直肠癌（CRC）肿瘤免疫微环境之间的关系。方法：对160例接受根治性切除的CRC患者的肠系膜淋巴结进行组织学检查。对淋巴结扩张（定义为窦扩张伴窦巨噬细胞丢失）进行定量，并将其与临床病理因素、全身炎症标志物以及原发肿瘤中的免疫细胞浸润（通过IHC检测CD3、CD8、Foxp3、Iba1、CD163）进行相关性分析。结果：淋巴结扩张在老年患者（≥70岁）和右侧结肠癌中显著更为常见（p=0.002）。淋巴结扩张明显的患者血清白蛋白和白细胞计数较低，提示存在全身性免疫衰老。免疫组化分析显示，高淋巴结扩张患者的肿瘤中CD8⁺细胞毒性T细胞及Iba1⁺/CD163⁺巨噬细胞的浸润显著减少，呈现出“冷”免疫微环境。然而，淋巴结扩张与预后并无直接相关性。结论：衰老相关的淋巴结扩张反映了区域淋巴结构的功能衰退，并与CRC中局部抗肿瘤免疫活性的减弱相关。淋巴结扩张可作为老年癌症患者淋巴结衰老和全身免疫抑制的组织病理学生物标志物。

查看英文原文 English abstract

Background: Lymph nodes (LNs) play a central role in anti-cancer immunity, yet the influence of aging on LN morphology and function in cancer remains largely unexplored. This study aimed to elucidate the relationship between aging-related LN alterations and the tumor immune microenvironment in colorectal cancer (CRC). Methods: Mesenteric LNs from 160 CRC patients who underwent curative resection were histologically examined. LN ectasia-defined as sinusoidal dilation with loss of sinus macrophages-was quantified and correlated with clinicopathological factors, systemic inflammatory markers, and immune cell infiltration in the primary tumor (CD3, CD8, Foxp3, Iba1, CD163 by IHC). Results: LN ectasia was significantly more frequent in elderly patients (≥70 years) and in right-sided colon cancers (p=0.002). Patients with marked LN ectasia showed lower serum albumin and leukocyte counts, indicating systemic immunosenescence. Immunohistochemical analysis revealed significantly reduced infiltration of CD8⁺ cytotoxic T cells and Iba1⁺/CD163⁺ macrophages in tumors from patients with high LN ectasia, representing a “cold” immune microenvironment. However, LN ectasia was not directly associated with prognosis. Conclusions: Aging-related LN ectasia reflects functional decline of regional lymphoid structures and correlates with attenuation of local anti-tumor immune activity in CRC. LN ectasia may serve as a histopathological biomarker of LN senescence and systemic immunosuppression in elderly cancer patients.

利益披露 Disclosure

K. Kanemitsu, None.. R. Yamada, None.. D. Yoshii, None.. Y. Fujiwara, None.. Y. Tagayasu, None.. T. Sako, None.. K. Arima, None.. K. Yamashita, None.. K. Harada, None.. N. Hanada, None.. Y. Komohara, None.. M. Iwatsuki, None.

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