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      Reduced number of CD169 + macrophages in pre‐metastatic regional lymph nodes is associated with subsequent metastatic disease in an animal model and with poor outcome in prostate cancer patients

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          Abstract

          Background

          Tumor‐derived antigens are captured by CD169 + (SIGLEC1 +) sinus macrophages in regional lymph nodes (LNs), and are presented to effector cells inducing an anti‐tumor immune response. Reduced CD169 expression in pre‐metastatic regional LNs is associated with subsequent metastatic disease and a poor outcome in several tumor types, but if this is the case in prostate cancer has not been explored.

          Methods

          CD169 expression was measured with immunohistochemistry in metastasis‐free regional LNs from 109 prostate cancer patients treated with prostatectomy (January 1996 to April 2002). Possible associations of CD169 expression with PSA‐relapse, prostate cancer death, Gleason score, and other clinical data were assessed using Kaplan‐Meier survival‐ and Cox regression analysis. In addition, the Dunning rat prostate tumor model was used to examine CD169 expression in pre‐metastatic LNs draining either highly metastatic MatLyLu‐ or poorly metastatic AT1‐tumors.

          Results

          In patients with low CD169 immunostaining in metastasis‐free regional LNs, 8 of the 27 patients died from prostate cancer compared with only three of the 82 patients with high immunostaining ( P < 0.001). CD169 expression in regional LNs was not associated with PSA‐relapse. Rats with highly metastatic tumors had decreased CD169 immunoreactivity in pre‐metastatic regional LNs compared with rats with poorly metastatic tumors.

          Conclusion

          Low expression of CD169 in metastasis‐free regional LNs indicates a reduced anti‐tumor immune response. If verified in other studies, CD169 expression in regional LNs could, in combination with other factors, potentially be used as a marker of prostate cancer aggressiveness.

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          Most cited references32

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          The metastatic niche: adapting the foreign soil.

          The 'seed and soil' hypothesis for metastasis sets forth the concept that a conducive microenvironment, or niche, is required for disseminating tumour cells to engraft distant sites. This Opinion presents emerging data that support this concept and outlines the potential mechanism and temporal sequence by which changes occur in tissues distant from the primary tumour. To enable improvements in the prognosis of advanced malignancy, early interventions that target both the disseminating seed and the metastatic soil are likely to be required.
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            The tumour-induced systemic environment as a critical regulator of cancer progression and metastasis.

            Recent pre-clinical and clinical research has provided evidence that cancer progression is driven not only by a tumour's underlying genetic alterations and paracrine interactions within the tumour microenvironment, but also by complex systemic processes. We review these emerging paradigms of cancer pathophysiology and discuss how a clearer understanding of systemic regulation of cancer progression could guide development of new therapeutic modalities and efforts to prevent disease relapse following initial diagnosis and treatment.
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              The pre-metastatic niche: finding common ground.

              It is rapidly becoming evident that the formation of tumor-promoting pre-metastatic niches in secondary organs adds a previously unrecognized degree of complexity to the challenge of curing metastatic disease. Primary tumor cells orchestrate pre-metastatic niche formation through secretion of a variety of cytokines and growth factors that promote mobilization and recruitment of bone marrow-derived cells to future metastatic sites. Hypoxia within the primary tumor, and secretion of specific microvesicles termed exosomes, are emerging as important processes and vehicles for tumor-derived factors to modulate pre-metastatic sites. It has also come to light that reduced immune surveillance is a novel mechanism through which primary tumors create favorable niches in secondary organs. This review provides an overview of our current understanding of underlying mechanisms of pre-metastatic niche formation and highlights the common links as well as discrepancies between independent studies. Furthermore, the possible clinical implications, links to metastatic persistence and dormancy, and novel approaches for treatment of metastatic disease through reversal of pre-metastatic niche formation are identified and explored.
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                Author and article information

                Contributors
                kerstin.stromvall@umu.se
                Journal
                Prostate
                Prostate
                10.1002/(ISSN)1097-0045
                PROS
                The Prostate
                John Wiley and Sons Inc. (Hoboken )
                0270-4137
                1097-0045
                07 September 2017
                01 November 2017
                : 77
                : 15 ( doiID: 10.1002/pros.v77.15 )
                : 1468-1477
                Affiliations
                [ 1 ] Department of Medical Biosciences Pathology Umeå University Umeå Sweden
                [ 2 ] Department of Surgical and Perioperative Sciences Urology and Andrology Umeå University Umeå Sweden
                Author notes
                [*] [* ] Correspondence

                Kerstin Strömvall, Department of Medical Biosciences, Pathology, Umeå University, Umeå SE‐90187, Sweden.

                Email: kerstin.stromvall@ 123456umu.se

                Author information
                http://orcid.org/0000-0001-7522-0997
                Article
                PROS23407
                10.1002/pros.23407
                5656907
                28880401
                8fe10b28-aa16-4de0-bbf5-01b4a8888650
                © 2017 The Authors. The Prostate Published by Wiley Periodicals, Inc.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 05 July 2017
                : 11 August 2017
                Page count
                Figures: 3, Tables: 4, Pages: 10, Words: 4344
                Funding
                Funded by: Cancerfonden
                Award ID: 130293
                Funded by: Vetenskapsrådet
                Award ID: Co257301
                Funded by: Västerbotten Läns Landsting
                Funded by: Lion's Cancer Research Foundation (Umeå University)
                Funded by: Swedish Cancer Society, the Swedish Research Council
                Funded by: County of Västerbotten
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                pros23407
                November 1, 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.2.1 mode:remove_FC converted:26.10.2017

                Sexual medicine
                dunning rat prostate tumors,immunohistochemistry,prostate cancer death,siglec1,tumor‐draining lymph nodes

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