Disturbed meningeal lymphatic function associated with malignancy and progression in patients with intracranial malignant tumors

Abstract

Meningeal lymphatic vessels (mLVs) have proven to bear a relationship with tumor immunity and therapeutic efficacy of intracranial malignant tumors in pre-clinical animal studies. We aimed to explore the association between mLV function and intracranial malignant tumors in clinical participants. The participants were allocated to a control group or a group of patients with intracranial tumors. Dynamic enhanced magnetic resonance was used to evaluate the wash-in and wash-out functions of mLVs around the superior sagittal sinus and the sigmoid sinus. A total of 246 individuals were recruited for our study. The area under curve and wash-in rate of mLVs in the intracranial tumor group were higher than in the control group (2,749 vs. 2,110, p<0.001 and 3.72 vs. 2.87, p<0.001, respectively). The wash-out ratio of mLVs was lower in the intracranial tumor group than in the control group (0.65 vs. 0.73, p<0.001). Decreased wash-out of mLVs was associated with tumor progression (β= -0.118; p<0.001). High-grade glioma and isocitrate dehydrogenase wild type were associated with a lower mLV wash-out function (β= -0.057, p= 0.044 and β= -0.069, p= 0.047, respectively). Intracranial malignant tumors were associated with elevated wash-in function and decreased wash-out function of mLVs. High-grade glioma and isocitrate dehydrogenase wild type were associated with low mLV wash-out function, and long-term decreased mLV wash-out function was a risk factor for tumor progression. There was no funding.