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Cancer Research 66, 10365, November 1, 2006. Published Online First October 23, 2006;
doi: 10.1158/0008-5472.CAN-06-2977
© 2006 American Association for Cancer Research

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Molecular Biology, Pathobiology, and Genetics

Preparing the "Soil": The Primary Tumor Induces Vasculature Reorganization in the Sentinel Lymph Node before the Arrival of Metastatic Cancer Cells

Chao-Nan Qian1,5, Bree Berghuis2, Galia Tsarfaty3, MaryBeth Bruch3, Eric J. Kort4, Jon Ditlev1, Ilan Tsarfaty3, Eric Hudson2, David G. Jackson6, David Petillo1, Jindong Chen1, James H. Resau2 and Bin Tean Teh1

Laboratories of 1 Cancer Genetics, 2 Analytical, Cellular, and Molecular Microscopy, 3 Molecular Oncology, and 4 Molecular Epidemiology, Van Andel Research Institute, Grand Rapids, Michigan; 5 Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, China; and 6 Medical Research Council Human Immunology Unit, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, United Kingdom

Requests of reprints: Chao-Nan Qian, Laboratory of Cancer Genetics, Van Andel Research Institute, 333 Bostwick Avenue Northeast, Grand Rapids, MI 49503. Phone: 616-234-5538; Fax: 616-234-5539; E-mail: chaonan.qian{at}vai.org or Bin Tean Teh, Laboratory of Cancer Genetics, Van Andel Research Institute, 333 Bostwick Avenue Northeast, Grand Rapids, MI 49503. Phone: 616-234-5296; Fax: 616-234-5297; E-mail: bin.teh{at}vai.org.

Sentinel lymph node (SLN) metastasis is the first step in the spreading of cancer in many malignancies. Tumor-reactive lymphadenopathy in SLNs has been observed for decades, but alterations of the lymphatic channels and vasculature in these nodes before the arrival of metastatic tumor cells remain unexplored. Using animal models, we show here that, before the establishment of metastasis in the SLN, there are reorganizations of the lymphatic channels and the vasculature. The node becomes a functional blood vessel–enriched and lymph vessel/sinus-enriched organ before metastasis. The enlargement of the lymph sinuses is correlated with the primary tumor weight. The newly emerged functional blood vessels develop from high endothelial venules (HEV), in which the proliferation rate of the endothelial cells is also significantly increased. Similar alterations of the HEVs are also characterized in the axillary lymph nodes from human breast cancer patients without the evidence of metastasis. These findings support the hypothesis that modification of the microenvironment for a secondary tumor (i.e., vasculature reorganization in the SLN) can be initiated by a primary tumor before and independent of the physical presence of metastatic cancer cells. (Cancer Res 2006; 66(21): 10365-76)




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