Using T Cell Responses In The Lymph Node To Predict Patient Outcome In Colorectal Cancer (40.16)

Colorectal cancer (CRC) is one of the leading causes of cancer death worldwide - over half of those diagnosed will die from the disease. An important role for the immune response in controlling CRC has been demonstrated in numerous animal models and in human patients. The extent of T cell infiltration in the primary tumour is a better predictor of survival in CRC patients than traditional staging. Further, recent data by our lab and others have shown a correlation between immune response gene expression and favourable patient outcome. Despite the presence of an immune response, tumours still develop and grow. We hypothesised that the T cell response in the lymph nodes, i.e. the site of immune response initiation, may be a better predictor of patient outcome than that of the primary tumour. To this end, we analysed T cell subsets in the lymph nodes of Dukes' Stage B colorectal cancer (non metastatic) in a cohort of patients from New Zealand who had clinical follow-up. We found that, as is true for CD8+ T cells infiltrating the primary tumour, the number of CD8+ T cells on the lymph nodes correlated with a favourable patient outcome. However, the number of total CD4+ T cells in the lymph node was not correlated with patient outcome. The subtypes of CD4+ and CD8+ T cells, e.g. regulatory, effector, memory, are yet to be investigated. However, our data shows that the anti-tumour immune response appears to be initiated effectively in the lymph node and implies that the tumour environment may act directly to down-modulate an effective immune response.