Abstract
Abstract The formation of extranodal tertiary lymphoid follicles and lymphoid cell aggregates has been described in nonmalignant conditions including autoimmune diseases and chronic inflammation as well as in cancer. Tumor-induced lymph node-like structures (LLS) participate in the host's antitumor immune response by driving intratumoral immune cell priming. We evaluated the host immune response by immunohistochemistry in 60 well differentiated small bowel NETs. A miRNA microarray analysis was also performed to identify a molecular signature of LLS presence. In 13/60 samples the immune response was organized as ectopic LLS. When present, LLS were localized at the invasive edge of the tumors and contained germinal centers in different stages of maturation. CD21+ dendritic cells were present within the follicular germinal centers, while CD3+ T cells were dispersed in the parafollicular cortex zone surrounding the CD20+ B cell area of the follicles. Time to progression of metastatic tumors was compared in an exploratory cohort of 5 patients with strong evidence of LLS vs 5 patients with no evidence of LLS and was substantially longer in the former group (94 vs 28 months; p = 0.15). Updated survival and miRNA microarray analysis will be presented at the meeting.The understanding of the functional nature of LLS may provide new insights into the pathogenesis of the disease, possibly furnishing a new tool for prognostic stratification and prediction of response to immune-based treatments. Citation Format: Mauro Cives, Jonathan Strosberg, Stacey A. Simons, Domenico Coppola. Significance of ectopic lymph node-like structures in neuroendocrine tumors of the small bowel. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1550. doi:10.1158/1538-7445.AM2015-1550
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