Abstract
Previous studies have revealed that high-intensity focused ultrasound (HIFU) ablation can trigger an antitumor immune response. The aim of this study was to investigate immune response in tumor-draining lymph nodes (TDLNs) after HIFU treatment. Forty-eight female patients with biopsy-confirmed breast cancer were divided into a control group and an HIFU group. In the control group, 25 patients underwent modified radical mastectomy, but 23 patients in the HIFU group received HIFU ablation of primary cancer, followed by the same operation. Using HE and immunohistochemical staining, the immunologic reactivity pattern and immune cell profile were assessed in paraffin-embedded axillary lymph nodes (ALNs) in all patients. The results showed that ALNs presented more evident immune reactions in the HIFU group than in the control group (100% vs. 64%). Among the ALNs, 78.3% had mixed cellular and humoral immune response, whereas 36% in the control group showed cellular immune response. The numbers of CD3+, CD4+, NK cell, and activated CTLs with Fas ligand+, granzyme+ and perforin+ expression were significantly higher in the ALNs in the HIFU group. It was concluded that HIFU could stimulate potent immune response and significantly increase T cell, activated CTLs and NK cell populations in the TDLNs of breast cancer.
Highlights
In our previous studies related to high-intensity focused ultrasound (HIFU) treatment for patients with breast cancer, we found clinical evidence that HIFU could induce immunological effects on antigen presenting cells (APCs) and tumor-infiltrating lymphocytes (TILs) in the primary cancer [14,15]
tumor-draining lymph nodes (TDLNs) are small peripheral lymphoid compartments that lie directly downstream of tumors. They are the most critical site where tumor antigens are typically first presented to the naïve immune system [17]
Local microenvironment in the TDLNs becomes a key determinant in setting the course of the subsequent antitumor immune response [19,20]
Summary
The lymphatic system constitutes an essential compartment of the immune system It transports antigens and immune cells from peripheral tissues to draining lymph nodes, and from there back into blood circulation. Tumor-draining lymph nodes (TDLNs) are peripheral secondary lymphoid organs that play an important role in host antitumor immunity. TDLNs are composed of different types of immune cells, including antigen presenting cells (APCs), natural killer (NK) cells and T and B lymphocytes. They are the primary site for tumor antigen presentation and lymphocyte activation through their organized compartments, and initiate a TDLN-mediated immune response in the antitumor immunity [2]. Immune response in the TDLNs may be a B-cell predominance that is characterized
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