For many diseases, the ability to quickly and effectively diagnose or prognose a patient is critical. If caught early on, doctors and patients are given the time to properly analyze and treat the disease, which often results in a far better outlook for the patient.
This is doubly true in cancer. If caught early, many cancers can be treated quite easily with surgery and follow-up chemotherapy or radiotherapy. A smaller and more localized cancer is usually easier to get rid of. Once a tumor progresses to metastasis, it becomes incredibly difficult to treat effectively.
Diagnostic and prognostic tests sensitive enough to catch cancer early are a huge area of interest for researchers. Many studies have put forward candidate indicators that might be able to track the prognosis of certain cancers. In a new study out of the Karolinska Institute in Sweden, a team of scientists sought to use T-cell populations in sentinel lymph nodes as a prognostic indicator for oral squamous cell carcinomas.
A sentinel lymph node is the lymph node cancer would have most likely reached first. Lymph nodes are critical organs of the immune system and are essentially responsible for filtering and identifying problematic things in your blood (cancer being one such example). It stands to reason that the T-cell (a type of immune cell) population of a sentinel node would be different than in another lymph node, as the immune system reacts to the cancerous cell’s being caught in the sentinel node.
To test their hypothesis, the team enrolled 28 oral squamous cell carcinoma patients into this new study. They would obtain samples of the tumor, the sentinel node, and a non-sentinel lymph node to measure their respective T-cell populations. The team found that when a patient had a low CD69 and C4 Positive T-cell population, there was a significant decrease in disease-free survival. This was also the case when the sentinel nodes had an increase in CD8 and CD HLA-DR, positive T-cell populations.
These results suggest that sentinel lymph nodes are affected by cancers. This results in a change in the T-cell population compared to non-sentinel lymph nodes. While this could very well be used as a prognostic indicator for oral squamous cell carcinoma patients, the team also notes it could reveal an altering of the immune system at the lymph nodes. Cancer is already known to alter the immune environment surrounding a tumor. If it could also affect the immune system at other locations before metastasis, identifying these locations might assist future therapies.
The study concludes, “We demonstrate that the use of flow cytometry to characterize activation of T-cells in sentinel node may serve as an important prognostic marker, which could improve patients’ surveillance strategy and overall survival.”