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Shubitz, Lisa. "Coccidioides Lymph Node Histopathology." The University of Arizona, 2016. http://hdl.handle.net/10150/620043.
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White, Andrea Jane. "Mechanisms regulating lymph node organogenesis." Thesis, University of Birmingham, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.487169.
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The fonnation of organised microenvironments within lymph nodes(LN) occurs during development and is essential to support effective immune responses. Organogenesis ofLNs requires interactions between LTI* expressing mesenchymal stromal organiser cells and LTaJI32 expressing hematopoietic LTi cells. This activates the NF-KB signalling pathway, inducing expression of chemokines and adhesion molecules that are essential for the continued recruitment and retention ofLTi cells, and ultimately the recruitment oflymphocytes to the iLN. However the cellular and molecular mechanisms ofLN development are still unclear. This study has developed novel techniques to study iLN development, including the isolation ofiLN from embryos, the generation of LTi cells in vitro, and the reaggregation and transplantation ofdifferent cellular subsets to study their interactions in vivo. We have identified a programme ofstromal cell development, related this to the role of LTi cells in iLN organogenesis and identified LT independent and LT dependent phases ofiLN development. Finally a potential precursor/product relationship between fetal LTi cells and adult CD4+CD3- cells has also been highlighted as a result ofphenotypic analysis and precursor-product relationships. To conclude, this thesis contains a detailed study into the cellular requirements and molecular mechanisms involved in iLN organogenesis.
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Kelder, Wendy. "Lymph node staging in colon cancer." [S.l. : Groningen : s.n. ; University Library of Groningen] [Host], 2008. http://irs.ub.rug.nl/ppn/305609017.
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Woolgar, Julia Anne. "Lymph node metastasis in oral cancer." Thesis, University of Liverpool, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.260368.
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LeBedis, Christina. "Lymph node involvement in breast carcinoma metastasis." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=31255.
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Since lymph node stromal cells remain largely uncharacterized with respect to cell surface markers and function, their role in regulating the growth and invasion of disseminated cancer cells, including breast carcinoma has, to date, been virtually unexplored. In the present study, we asked whether peripheral lymph node cells could modulate the growth of breast carcinoma cells and, thereby, contribute to the progression of the metastatic process. Primary cultures of rat peripheral lymph node stromal cells were obtained by limiting dilution and two sublines, STA4 and STB12, with breast carcinoma growth-promoting activities were isolated. Immunocytochemistry performed on these cells revealed that they express vimentin, S-100 and fibronectin, but neither cytokeratin nor von Willebrand factor indicating that they are stromal and dendritic in origin. Several functional studies were performed using media conditioned by STA4 and STB12 cells. (Abstract shortened by UMI.)
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Cronin, Laura. "The chronic lymphocytic leukaemia lymph node microenvironment." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/6787/.
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The lymph node (LN) microenvironment in Chronic Lymphocytic Leukaemia (CLL) is the main site of disease progression and maintenance. Whilst isolated components of the LN niche have been studied in vitro, to date, no comprehensive architectural overview of the microenvironment has been attempted. A more holistic view is essential in order to fully understand this disease. LN CLL cells are likely to receive a complex array of survival signals from accessory cells which drive disease and protect against conventional therapeutics. This study embarked upon establishing reliable combinations of primary and secondary antibodies that permit multicolour immunohistochemistry (IHC) interrogation of the CLL LN in formalin fixed paraffin embedded samples (FFPE). This work serves to demonstrate that the architecture of the CLL microenvironment is complex, dynamic and heterogeneous and highlights the advantages multicolour IHC can present to the field for understanding the therapeutic opportunities in this disease.
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Sahalan, Mariaulpa. "Diffusion-weighted Imaging of Lymph Node Tissue." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/20070.
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Purpose: The study investigates the hypothesis of clinically observed decreased apparent diffusion coefficient (ADC) of cancerous lymph nodes can be attributed to increased cellularity. The study characterises the mean diffusivity (MD) of lymph node sub-structures and investigates correlation between MD and cellularity metrics. The study also investigates the theoretical information content of single and multi-biophysical models. Methods:. A 3 mm diameter core sample was extracted from a formalin fixed lymph node tissue post-surgery and imaged using 9.4T and 16.4T Bruker MRI system. Samples were sectioned and stained with haematoxylin and eosin (H&E). Diffusion tensor model was fitted voxelwise and MD values were computed using Matlab. Cellularity metrics includes measurement of nuclear count and nuclear area. Eleven models with combinations of isotropic, anisotropic, and restricted components were tested for diffusion modelling and ranked using the Akaike information criterion (AIC). Results: The findings showed distinct diffusivities of lymph node sub-structures (capsule and parenchyma). Parenchyma in normal lymph node tissues had higher MD (0.71 ± 0.17 µm2/ms) than metastatic parenchyma (0.52 ± 0.08 µm2/ms) and lymphoma (0.47 ± 0.19 µm2/ms). No correlation were observed between MD and nuclear count (r = 0.368) and nuclear area (r = 0.368) respectively at 95 % confidence intervals. The single biophysical models (ADC and DTI) were ranked lowest by AIC. Multi-biophysical models consist of anisotropic and restricted diffusion (Zeppelin-sphere, Ball-stick-sphere, and Ball-sphere) were ranked highest in the majority of voxels of the tissue samples. Conclusion: A distinct diffusivity value were found in lymph node sub-structures with no correlation to cellularity. Multi-biophysical models were ranked highest and extract more information from the measurement data than simple single biophysical models.
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Newman, Lisa. "Intranasal infection with streptococcus pneumoniae induces pericyte relaxation and subsequent lymph node hypertrophy in the lung draining lymph node." Thesis, University of York, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.516369.
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Malhotra, Deepali. "Insights into the Transcriptional Identities of Lymph Node Stromal Cell Subsets Isolated from Resting and Inflamed Lymph Nodes." Thesis, Harvard University, 2012. http://dissertations.umi.com/gsas.harvard:10678.
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Non-hematopoietic stromal cells (SCs) promote and regulate adaptive immunity through numerous direct and indirect mechanisms. SCs construct and support the secondary lymphoid organs (SLOs) in which lymphocytes crawl on stromal networks and inspect antigen-presenting cells for surface-display of cognate antigens. SCs also secrete survival factors and chemotactic cues that recruit, organize, and facilitate interactions among these leukocytes. They influence antigen access by secreting and ensheathing extracellular matrix-based conduit networks that rapidly convey small, soluble lymph-borne molecules to the SLO core. Furthermore, lymph node stromal cells (LNSCs) directly induce \(CD8^+\) T cell tolerance to peripheral tissue restricted antigens and constrain the proliferation of newly activated T cells in these sites. Thus, stromal-hematopoietic interactions are crucial for the normal functioning of the immune system. LNSCs are extremely rare and difficult to isolate, hampering the thorough study of their biology. In order to better understand these stromal subsets, we sorted fibroblastic reticular cells (FRCs), lymphatic endothelial cells, blood endothelial cells, and podoplanin \(^−CD31^−\) cells (double negative stromal cells; DNCs) to high purity from resting and inflamed murine lymph nodes. We meticulously analyzed the transcriptional profiles of these freshly isolated LNSCs as part of the Immunological Genome Project Consortium. Analysis of the transcriptional profiles of these LNSC subsets indicated that SCs express key immune mediators and growth factors, and provided important insights into the lymph node conduit network, FRC-specialization, and the DNC identity. Examination of hematopoietic and stromal transcription of ligands and cognate receptors suggested complex crosstalk among these populations. Interestingly, FRCs dominated cytokine and chemokine transcription among LNSCs, and were also enriched for higher expression of these genes when compared with skin and thymic fibroblasts, consistent with FRC-specialization. LNSCs that were isolated from inflamed lymph nodes robustly upregulated expression of genes encoding cytokines, chemokines, antigen-processing and presentation machinery, and acute-phase response molecules. Little-explored DNCs showed many transcriptional similarities to FRCs, but importantly did not transcribe interleukin-7. We identified DNCs as consisting largely of myofibroblastic pericytes that express integrin \(\alpha 7\). Together these data comprehensively describe the transcriptional characteristics of four major LNSC subsets isolated from resting and inflamed SLOs, offering many avenues for future study.
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Woodruff, Matthew Charles. "Structure and Function of the Murine Lymph Node." Thesis, Harvard University, 2014. http://nrs.harvard.edu/urn-3:HUL.InstRepos:13102331.
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Lymph nodes (LNs) are dynamic organs responsible for providing a supportive and centralized environment for the generation of immune response. Utilizing a highly organized network of non-hematopoietic stromal cells, the LN serves as the context in which the immune system collects and presents antigen, promotes innate and adaptive immune interaction, and generates protective cell-mediated and humoral immunity. In this way, proper organization and function of the LN environment is a critical component of effective immunity, and understanding its complexity has direct impact on the ability to generate and modulate primary immune response to specific antigens. To this end, the LN architecture, underlying stromal networks, and environmental and cellular responses to influenza vaccination were investigated. Using novel approaches to conduit imaging, details of the collagen network that comprises the LN scaffolding have been integrated into current understandings of LN architecture. The cellular compartment responsible for the maintenance of that scaffolding, fibroblastic reticular cells (FRCs), have been studied using an induced diptheria toxin receptor model. By specifically ablating the FRC population in mice, their role in the maintenance of T cell homeostasis has been confirmed in vivo. More surprisingly, a disruption of the FRC network resulted in a loss of B cell follicle structure within LNs, and a reduction in humoral immunity to influenza vaccination. These findings led to the identification of a new subset of FRCs which reside in B cell follicles, and serve as a critical source of the B cell survival factor BAFF. Turning towards the hematopoietic response to influenza vaccination, a highly unexpected lymph node resident dendritic cell (LNDC) response has been identified following vaccine antigen deposition within specialized sites in the LN medulla. Rapid migration of LNDCs into these sites optimizes exposure of the population to viral antigen, and de novo synthesis of a CXCL10 chemokine gradient by activated LNDCs ensures efficient antigen specific \(CD4^+\) T cell response, and protective humoral immunity - independent of migratory dendritic cell status. Altogether, these studies highlight a highly dynamic, responsive LN environment with direct influence on primary immune response - the understanding of which has broad implications in vaccine biology.
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Richardson, Keith. "Sentinel lymph node biopsy for papillary thyroid cancer." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=114194.
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Objective: To prospectively evaluate the role of sentinel lymph node (SLN) biopsy in the management of well differentiated thyroid carcinoma (WDTC)Methods: I designed and implemented a SLN biopsy protocol and subsequently performed it on consecutive patients undergoing thyroid surgery. Thyroid nodules were injected with methylene blue dye. A central compartment neck dissection (CCND) was performed. Frozen section analysis of the SLNs was performed.Results: 157 patients are included in this study. 94 patients had WDTC. Sevently three percent (69/94) of WDTC patients were found to have detectable SLNs. Twenty percent (14/69) of patients with SLNs were found to have central compartment metastases. The sensitivity, specificity, positive predictive value and negative predictive value of our SLN biopsy technique to remove all disease from the central compartment was 92.9%, 100%, 100% and 98.8% respectively (p < 0.0001). Conclusion: This data series suggests that if a patient has SLNs deemed as negative for malignancy on frozen section, the rest of the central compartment is unlikely to have lymph node metastasis.Contexte: Notre objectif est d'évaluer prospectivement le rôle du biopsy ganglion sentinelle dans la gestion du cancer de la thyroïde bien différencié Méthodes: Nous avons conçu et mis en place un protocole de biopsie du ganglion sentinelle et par la suite effectuées notre protocol sur des patients consécutifs subissant une thyroïdectomie. Les nodules ont été injectés avec du bleu de méthylène. Un dissection du cou central a été effectuée. Examen intra-operatoire des ganglion a été réalisée.Résultats: 157 patients sont inclus dans cette étude. 94 patients avaient un dissection central du cou. 73% (69/94) des patients ont été trouvés à avoir ganglion détectable. 20% (14/69) des patients atteints de ganglion ont été trouvés à avoir des métastases compartiment central. La sensibilité, spécificité, valeur prédictive positive et valeur prédictive négative de notre technique de biopsie du ganglion sentinelle pour enlever toutes les maladies à partir du compartiment central était de 92,9%, 100%, 100% et 98,8% respectivement (p <0,0001).Conclusion: Cette série de données volumineux suggère que si un patient a jugé comme négatif intra-operatoire de malignité sur la section gelée, un dissection central peut être preventire.
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Van, Trappen Philippe Octaaf. "Lymphangiogenesis and lymph node microdissemination in cervical cancer." Thesis, Queen Mary, University of London, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.408026.
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Clark, Richard R. "Lymph node metastasis in auricular squamous cell carcinoma." Thesis, University of Glasgow, 2009. http://theses.gla.ac.uk/547/.
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Introduction Squamous cell carcinoma of the auricle has an unusually high rate of lymph node metastases when compared to similar tumours at other sites. The lymph nodes affected are close to the base of the skull and in the neck. Development of metastasis carries a poor prognosis and most patients will subsequently die of failure of loco-regional control. Despite the likelihood of a poor outcome nothing can be done for patients prior to development of metastasis, as the risk of spread is not sufficiently high to warrant intervention in all patients. They are therefore treated with a ‘wait and see policy’ and only offered treatment once clinical evidence of metastatic spread is detected. This thesis sets out to examine what can be done, at the time of initial presentation with an auricular squamous cell carcinoma to identify patients who would benefit from treatment to the regional lymph node basins. Materials and Methods The thesis is divided into four separate studies. A systematic review examines the evidence available to date, an anatomical study examines the lymphatic drainage of the auricle in cadavers, a sentinel lymph node biopsy study examines the use of this technique to identify early tumour spread and a retrospective analysis of cases of auricular squamous cell carcinoma in our unit examines histopathological prognostic indictors of metastatic spread. Results The systematic review found that these tumours have a metastatic rate of about 11%. Patients developing metastasis usually die from failure of loco-regional control. Depth of tumour invasion, tumour size and mode of invasion seem to be potential indicators of metastatic risk. There is a strong argument for prophylactic intervention to the regional lymph nodes but there is no consensus of opinion as to when this should be carried out The anatomical study comprised 5 cadaveric dissections. They showed that the first echelon nodes draining the auricle lie in the superficial parotid gland, post-auricular/ mastoid nodal group and level II of the neck. There are anastamotic pathways around the mastoid and post-auricular nodes that could permit embolic tumour cells to bypass them. Five lymphatic pathways draining the auricle are described and some of these lie on the lateral and anterior surfaces of the mastoid bone and traverse the insertion of sternocleidomastoid. 28 cases of auricular squamous cell carcinoma were enrolled for sentinel lymph node biopsy. None of them were found to have any metastatic spread. One case showed non-viable tumour cells in a lymph node. There was a high incidence of complications (14%) directly related to the sentinel node biopsy procedure. The retrospective analysis identified 229 cases of auricular squamous cell carcinoma treated in our unit from 1992 - 2004. 212 of these cases had the primary pathology available for analysis. 24 (of 212) patients developed metastasis. 17 patients died as a result of their disease usually due to failure of control at the regional lymph node basin. Primary tumours with a depth of invasion greater than 8mm have metastatic rate of 56%. Tumours with a depth of invasion between 2-8mm and evidence of cartilage destruction, lymphovascular invasion or a non-cohesive invasive front have 24% metastatic rate. Tumours outwith these high-risk groups did not metastasise. Conclusions Elective lymph node dissections of the superficial parotid gland, post-auricular/mastoid and level II nodes should be considered in patients with primary auricular squamous cell carcinomas with a depth of invasion >8mm or a depth of invasion between 2 - 8 mm and evidence of cartilage destruction, lymphatic invasion or a non-cohesive invasive front. This should ideally be done as part of an observational study to evaluate the cost / benefit ratio for these patients. The neck dissection must clear the mastoid bone to a sub-periosteal level on its anterior and lateral surfaces. This will require the removal of the upper portion of sternocleidomastoid. Sentinel lymph node biopsy requires further study to evaluate it as a method for early detection of metastatic spread in auricular squamous cell carcinoma. This could be done as part of an observational study of elective neck dissections.
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Sato, Fumiaki. "Study on lymph node micrometastasis and expression of molecular biological factors in the process of lymph node metastasis in esophageal Cancer." Kyoto University, 2000. http://hdl.handle.net/2433/151438.
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Wahed, Shajahan. "Minimally invasive sentinel lymph node biopsy in oesophageal adenocarcinoma." Thesis, University of Newcastle upon Tyne, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.720011.
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Introduction and Aims Sentinel lymph nodes are the first nodes draining a primary tumour and the most likely sites of early metastases. A minimally invasive technique of identifying sentinel nodes in oesophageal adenocarcinoma could revolutionise management by determining whether patients with submucosal disease can be treated solely by endoscopic resection and whether other patients are suitable for a less radical lymphadenectomy. We evaluated a laparoscopic technique of identifying abdominal sentinel lymph nodes in patients with oesophageal adenocarcinoma and assessed whether these nodes could predict overall lymph node status. Methods This trial recruited patients with lower-third oesophageal adenocarcinoma planned for two-stage oesophagectomy with two-field lymphadenectomy. Sentinel node identification occurred immediately before resection, following endoscopic submucosal injection of 99mTechnetium-nanocol!oid. A laparoscopic gamma probe measured radioactivity from all nodal stations at laparoscopy, from the open abdomen, from the mediastinum following thoracotomy and ex vivo following removal of the specimen. Sentinel nodes had in vivo radioactivity greater than twice and ex vivo greater than 10 times background. Specimens were examined using haematoxylin and eosin and immunohistochemistry. Results A total of 1297 lymph nodes were examined from 40 patients (median 31 nodes). The median age and BMI were 65.5years and 26.5kg/m2 re s pectively. The overall sentinel node detection rate was 85% and sensitivity 88%. The laparoscopic abdominal sentinel node detection rate was 58% (23/40). Lymph node metastases were identified in 13 of these 23 patients, in whom laparoscopic abdominal sentinel nodes were positive in 10 but negative in three (sensitivity 77%). Two of these negative patients had mediastinal sentinel node micrometastases. Eleven patients had only mediastinal sentinel nodes. Five patients had no sentinel nodes. Adhesions prevented laparoscopy in one patient. Conclusions Laparoscopic identification of abdominal sentinel lymph using 99mTechnetium in patients with oesophageal adenocarcinoma was safe and technically feasible but not sensitive enough to predict overall nodal status.
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Doting, Meintje Hylkje Edwina. "Sentinel lymph node biopsy in breast cancer and melanoma." [S.l. : [Groningen : s.n.] ; University Library Groningen] [Host], 2007. http://irs.ub.rug.nl/ppn/300326254.
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Chen, Wan Qing. "Predictors of Auxillary Lymph Node Involvement in Screen Detected Breast Cancer." Thesis, The University of Sydney, 2004. http://hdl.handle.net/2123/676.
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Background: Axillary lymph node dissection as routine part of breast cancer treatment has been questioned in relation to the balance between benefits and morbidity. The purpose of this study is to determine the association of tumor size, age and histological grade with axillary lymph node metastasis, to determine if some patients could be exempted from axillary dissection. Methods: The data are derived from BreastScreen NSW, the government sponsored population-based breast screening program. In New South Wales (NSW) Australia between 1995 and 2002, 7,221 patients with invasive breast carcinoma were diagnosed and 5,290 patients were eligible for this study. The relationship between incidence of positive axillary lymph nodes and three study factors (tumor size, age and histological grade) was investigated by univariate and multivariate analysis. Logistic regression models were used to predict probability of axillary metastases. Results: The incidence of axillary lymph node metastases was 28.6% (95% CI: 27.4%- 29.8%). Univariate analysis showed that age, tumor size and histological grade were significant predictors of axillary lymph node metastases (p<0.0001). Multivariate analysis identified age, tumor size and histological grade remained as independent predictors (p<0.0001). From multivariate analysis, patients with T1a (Less than or equal to 5mm) and grade I tumors regardless of age had 5.2% (95% CI: 1.2%- 9.3%) frequency of node metastases. Patients 70 years or older with grade I, T1a and T1b (6-10mm) tumors had 4.9% (95% CI: 3.2%- 7.5%) and 6.6% (95% CI: 5.3%-8.3%) predicted frequency of node metastases. Conclusions: Tumor size, age and histological grade are predictors of axillary lymph node metastases. Routine axillary lymph node dissection could be avoided in some patient groups with a low frequency of involved lymph nodes if the benefits are considered to exceed the risks.
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Chen, Wan Qing. "Predictors of Auxillary Lymph Node Involvement in Screen Detected Breast Cancer." University of Sydney. Public Health, 2004. http://hdl.handle.net/2123/676.
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Background: Axillary lymph node dissection as routine part of breast cancer treatment has been questioned in relation to the balance between benefits and morbidity. The purpose of this study is to determine the association of tumor size, age and histological grade with axillary lymph node metastasis, to determine if some patients could be exempted from axillary dissection. Methods: The data are derived from BreastScreen NSW, the government sponsored population-based breast screening program. In New South Wales (NSW) Australia between 1995 and 2002, 7,221 patients with invasive breast carcinoma were diagnosed and 5,290 patients were eligible for this study. The relationship between incidence of positive axillary lymph nodes and three study factors (tumor size, age and histological grade) was investigated by univariate and multivariate analysis. Logistic regression models were used to predict probability of axillary metastases. Results: The incidence of axillary lymph node metastases was 28.6% (95% CI: 27.4%- 29.8%). Univariate analysis showed that age, tumor size and histological grade were significant predictors of axillary lymph node metastases (p<0.0001). Multivariate analysis identified age, tumor size and histological grade remained as independent predictors (p<0.0001). From multivariate analysis, patients with T1a (Less than or equal to 5mm) and grade I tumors regardless of age had 5.2% (95% CI: 1.2%- 9.3%) frequency of node metastases. Patients 70 years or older with grade I, T1a and T1b (6-10mm) tumors had 4.9% (95% CI: 3.2%- 7.5%) and 6.6% (95% CI: 5.3%-8.3%) predicted frequency of node metastases. Conclusions: Tumor size, age and histological grade are predictors of axillary lymph node metastases. Routine axillary lymph node dissection could be avoided in some patient groups with a low frequency of involved lymph nodes if the benefits are considered to exceed the risks.
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Hess, Estelle. "RANK and the regulation of lymph node and skin homeostasis." Strasbourg, 2011. https://publication-theses.unistra.fr/public/theses_doctorat/2011/HESS_Estelle_2011.pdf.
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Le récepteur activant NF-κB (RANK), connu pour son rôle dans le remodelage osseux, est aussi impliqué dans le développement d’appendices de la peau et dans la biologie des cellules épithéliales, amenant la question de son rôle dans la peau et les follicules pileux (FP). Nous avons montré que les souris déficientes pour RANK ou son ligand (RANKL) ne peuvent initier une nouvelle phase du cycle pileux et qu’elles présentent une homéostasie de l’épiderme altérée. De plus, la surexpression de RANK dans les cellules souches (CS) des FP et l’administration de RANKL activent le cycle pileux et la croissance de l’épiderme. Les CS du FP expriment RANK et RANKL est activement transcrit par le FP en croissance mettant en évidence le rôle de RANK dans l’activation des CS pour l’entrée dans le cycle pileux. En plus de ces fonctions, RANK est requis pour le développement des ganglions lymphatiques (GL). Cette fonction est partagée avec le récepteur de la lymphotoxine LTβR qui est de plus impliqué dans le maintien de l’organisation du GL. Nous avons donc étudié la fonction de RANK dans le GL adulte en travaillant sur des souris surexprimant RANK dans le FP et développant une hyperplasie des GL drainant la peau. Ces GL présentent une proportion de cellules hématopoïétiques et stromales normale. Nous avons montré que RANKL dérivé de la peau induit la prolifération des cellules stromales ainsi que l’expression de chemokines et de molécules d’adhésion, déclenchant la croissance du GL. Ainsi nous avons décrit une nouvelle fonction de RANK dans le contrôle de la plasticité du GL et souligné l’importance des signaux dérivés des tissus pour l’homéostasie des organes lymphoïdes secondairesThe receptor activator of NF-κB (RANK) is known to control bone mass and development of the skin appendages. This, and its function in epithelial cell biology in general, incited us to investigate the role of RANK in skin and hair follicles (HFs). We show that mice deficient in RANK or RANK-ligand (RANKL) are unable to initiate a new growth phase of the hair cycle and display arrested epidermal homeostasis. Transgenic mice overexpressing RANK in the HF and administration of recombinant RANKL activate the hair cycle and epidermal growth. RANK is expressed by HF stem cells and RANKL is actively transcribed by the growing HF supporting a role of RANK-activation of stem cells for hair cycle entry. In addition to its function in bone and skin, RANK is required for development of lymph nodes (LNs), a feature shared with lymphotoxin β receptor (LTβR). However, LTβR is further involved in the maintenance of LN organization, which had not been demonstrated for RANK. We therefore addressed the question of the function of RANK in LNs beyond development. For this, we took advantage of the transgenic mice overexpressing RANK in the HF, as they displayed a massive post-natal growth of skin-draining LNs. They displayed conserved proportions of hematopoietic and stromal cells, but an increase in the number of small B cell follicles. We showed that skin-derived RANKL induces LN stromal cell proliferation and expression of chemokines and adhesion molecules, resulting in the LN growth. This work highlighted an additional function for RANK-signaling in LNs, namely its control of LN plasticity, and underlines the importance of tissue-derived cues for secondary lymphoid organ homeostasis
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Shayan, Raheleh. "CXCL12/CXCR4 in embryonic lymphatic vasculature and lymph node formation." Thesis, Aix-Marseille, 2019. http://www.theses.fr/2019AIXM0304.
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Nous avons étudié le rôle de l’axe CXCL12 / CXCR4 dans la période initiale de formation de LN, de E12.5 à E14.5. Nous avons utilisé le modèle rapporteur Cxcl12DsRed et généré des embryons de KO généraux à l'aide de Cxcl12DsRed, ce qui nous a permis d'étudier les effets de cette suppression sur les embryons. Il en résultait beaucoup moins de cellules dans le LN anlagen cervical et mandibulaire, ce qui se reflétait dans la quantité totale de LTi4 dans l'embryon. Nous avons également éliminé Cxcr4 de manière conditionnelle sur les CSH en utilisant des souris Vavicre croisées avec des souris Cxcr4flox. Il en résultait moins de cellules LTi dans le LN anlagen mandibulaire. Pour déterminer si l'endothélium des vaisseaux sang est la source de CXCL12 impliquée dans l'initiation de la formation de LN, nous avons utilisé Cxcl12Tie2KO, qui n'a cependant eu aucun effet sur la formation de LN. Pour supprimer Cxcl12 de l'autre source au sein de LN anlagen, les cellules mésenchymateuses, nous avons utilisé NestinCre pour entraîner Cxcl12flox. Dans ce modèle, nous avons observé une diminution modeste du nombre de cellules LTi dans le LN anlagen mandibulaire, mais pas de reflet du Cxcl12 KO complet. Pour établir que CXCL12 est impliqué dans la rétention des cellules LTi au sein du LN anlagen, nous avons bloqué la signalisation CXCR4 juste avant l'isolement des embryons à E13.5 à l'aide de Plerixafor ou AMD31000. Nous avons observé que les cellules LTi ont commencé à sortir du LN anlagen et à former du LN anlagen en vrac et plus étendu. Par conséquent, nous avons conclu que CXCL12 / CXCR4 était impliqué dans la rétention des cellules LTi au sein du LN anlagenuinsWe investigated the role of the CXCL12/CXCR4 axis in the initial period of LN formation, from E12.5 until E14.5. We used the Cxcl12DsRed reporter model and generated general KO embryos using Cxcl12DsRed, which allowed us to investigate the effects of this deletion on embryos. It caused significantly less cells in the cervical and mandibular LN anlagen which was reflected in the total amount of LTi4 in the embryo. Also, we conditionally knocked out Cxcr4 on HSCs using Vavicre mice crossed with Cxcr4flox mice. This resulted in less LTi cells in the mandibular LN anlagen. To establish if the blood vessel endothelium is the source of CXCL12 involved in initiation of LN formation, we used Cxcl12Tie2KO, which, however, had no effect on the LN formation. To delete Cxcl12 from the other source within the LN anlagen, the mesenchymal cells, we used NestinCre to drive Cxcl12flox. In this model, we observed a modest decrease in the number of LTi cells in the mandibular LN anlagen but no reflection of the complete Cxcl12 KO. To establish that CXCL12 is involved in retention of LTi cells within the LN anlagen, we blocked CXCR4 signaling just before isolation of the embryos at E13.5 using Plerixafor or AMD31000. We observed that the LTi cells started to move out from the LN anlagen and form loose and more spread LN anlagen. Therefore, we concluded that CXCL12/CXCR4 was involved in retaining the LTi cells within the LN anlagen
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Korowlay, Nisaar Ahmed. "The use of lymphoscintigraphy to localise the sentinel lymph node." Master's thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/2802.
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Includes bibliographical references (leaves 72-90).Sentinel lymph node (SLN) biopsy is being used increasingly for staging early breast carcinoma in place of complete axillary lymph node dissection. The optimal method to identify the SLN and has not been clearly elucidated in the literature. A number of techniques have been proposed for identifying SLN/s. The main debate centres on whether to use a blue dye or radiopharmaceutical method either singly or in combination.
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Foerster, Susann. "Gene expression profiling of human lymph node-positive gastric adenocarcinomas." Doctoral thesis, Humboldt-Universität zu Berlin, Mathematisch-Naturwissenschaftliche Fakultät I, 2011. http://dx.doi.org/10.18452/16259.
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In dieser Arbeit wurden Genexpressionsprofile diffuser und intestinaler Magenadenokarzinome mittels Microarray-Technik erstellt. Der intestinale Typ konnte als stark proliferierender Tumor mit signifikanter Überexpression von zellzyklusrelevanten Genen definiert werden, während der diffuse Typ als stark stromaabhängig mit signifikanter Überexpression von Genen der extrazellulären Matrix hervortrat. Thrombospondin 4 (THBS4) wurde dabei als das am stärksten differentiell exprimierte Gen identifiziert, wobei seine mRNA in diffusen Tumoren eminent überexprimiert wird. Immunhistochemische Studien bestätigten diese starke Überexpression auf Proteinebene und zeigten, dass THBS4 eine übermäßig angereicherte extrazelluläre Komponente des Tumorstromas ist. Kolokalisierungsstudien zeigten zudem, dass THBS4-positive Zellen auch positiv für Vimentin und Smooth muscle actin (alpha) sind. Diese Ergebnisse belegen, dass THBS4 von Tumor-assoziierten Fibroblasten (TAF) exprimiert wird. Dies konnte durch zusätzliche in vitro Experimente bestätigt werden, die aufzeigten, dass TAF von diffusen Tumoren eine stärkere THBS4-mRNA Expression aufweisen als normale Fibroblasten des Magens. Abschließend konnten in vitro Kokultur-Studien aufdecken, dass die THBS4-Expression in Fibroblasten durch Tumorzellen diffuser Magentumore transkriptionell stimuliert wird. Metastasenbefall regionaler Lymphknoten (N+) ist bei den meisten Magenadenokarzinomdiagnosen bereits vorhanden. Dieser ist der stärkste derzeit verfügbare Parameter zur Abschätzung der Prognose, reicht aber für eine eindeutige Vorhersage nicht aus. Um ergänzende molekulare Prognoseindikatoren zu identifizieren, wurden aus den Microarray-Daten Gene, deren Expression mit dem klinischen Verlauf von N+ Patienten korreliert, extrahiert. Einige dieser Gene, z.B. RAN binding protein 17 und ras-related associated with diabetes, konnten mittels quantitativer real-time PCR als Marker für verkürztes progressionsfreies Überleben validiert werden.In this work, gene expression profiles of diffuse and intestinal-type gastric adenocarcinomas were established using the microarray technique. The intestinal type was identified to be a highly proliferative entity with significant overexpression of cell cycle-relevant genes, whereas the diffuse type was proven to be strongly stroma-dependent with significant overexpression of extracellular matrix genes. Thrombospondin 4 (THBS4) was identified as the gene most differentially expressed between the two types with vast mRNA overexpression in diffuse-type tumors. Immunohistochemical studies proved overexpression on protein level and elucidated that THBS4 is a heavily accumulated extracellular constituent of the tumor stroma. Colocalization studies uncovered that THBS4-positive cells are also positive for vimentin and alpha-smooth muscle actin. These data signify that THBS4 is expressed by subpopulations of cancer-associated fibroblasts (CAFs). This was further evidenced by in vitro experiments demonstrating that THBS4 mRNA expression is increased in CAFs of diffuse-type tumors compared to normal gastric fibroblasts. Finally, in vitro coculture studies revealed that transcriptional THBS4 expression in fibroblasts is stimulated by diffuse-type gastric tumor cells. Metastatic involvement of regional lymph nodes (N+) usually accompanies diagnosis of gastric adenocarcinoma and is currently considered the most important parameter for assessment of prognosis. However, estimation of prognosis based on this parameter alone is not sufficiently reliable. In order to identify additional molecular prognosis markers, genes whose expression correlates with clinical outcome of N+ patients were extracted from the microarray data. Via quantitative real-time PCR, several genes, e.g. RAN binding protein 17 and ras-related associated with diabetes, were successfully validated to allow an expression-based stratification of patients with respect to disease-free survival.
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Ahlgren, Johan. "Studies on Prediction of Axillary Lymph Node Status in Invasive Breast Cancer." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/theses/91-554-5221-3/.
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Freud, Aharon G. "Studies of human natural killer cell development." Columbus, Ohio : Ohio State University, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1148068172.
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Duffy, Danelle M. "Influence of supramammary lymph node extract on cell growth in vitro." Connect to this title online, 2007. http://etd.lib.clemson.edu/documents/1181251756/.
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Chen, Wanqing. "Predictors of axillary lymph node involvement in screen-detected breast cancer." Connect to full text, 2004. http://setis.library.usyd.edu.au/adt/public_html/adt-NU/public/adt-NU20050104.165451/index.html.
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Thesis (M.I.P.H.)--School of Public Health, University of Sydney, 2004."This treatise is submitted in partial satisfaction of the requirements for the Degree of Master of International Public Health (Hons), University of Sydney". Bibliography: leaves 10-15.
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ANDALUR, NANDAGOPAL Saravanan. "Microfluidics-assisted investigation of T-lymphocyte Migration in lymph node relevant chemokine gradients." PLoS ONE, 2011. http://hdl.handle.net/1993/23247.
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T-lymphocytes (T-cells) trafficking in the lymph nodes (LNs) is key for T-cells activation and their effector functions in adaptive immune responses. T-cells enter the LNs through high endothelial venules (HEVs) and interact with dendritic cells (DCs) for cognate antigens in the T-cell zone (TCZ). After scanning the TCZ for antigens, T-cells leave the LNs through efferent lymphatic vessel. CCR7 and its ligands, CCL19 and CCL21 are involved in the recruitment and compartmentalization of T-cells in LNs. However, their specific role(s) in mediating T-cells migration in LNs sub-regions remain unclear. In addition, the mechanism behind the passage of T-cells from the TCZ to the abluminal side of medullary sinuses (for their exit through medullary sinuses) is not well understood. Here, I hypothesize that different CCL19 and CCL21 fields in LNs sub-regions, orchestrate T-cells sub-regional migration in LNs..
In this study, I examined the CCL19 and CCL21 distribution profiles in mouse LNs sub-regions by immunofluoroscence staining and confocal microscopy. Using microfluidic devices that can flexibly configure well-defined single and co-existing chemical concentration gradients, I quantitatively analyzed the migration of activated human blood T-cells in LNs relevant CCL19 and CCL21 fields. The results suggested a novel CCL19 and CCL21 based combinatorial guiding mechanism for T-cells migration in different LNs sub-regions. In particular, this mechanism operates in the TCZ periphery region to guide T-cells migration away from the TCZ. Furthermore, the CCL19 and CCL21 fields mimicking the region beyond the TCZ toward the medulla result in disturbed chemotaxis, which prevents T-cells from being attracted back to the TCZ. Taken together, this microfluidics-based in vitro study shows the coordinated T-cells migration in different single and combined CCL19 and CCL21 fields, leading to interesting new insights into the guiding mechanisms for T-cells trafficking in LNs sub-regions.
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von, Below Catrin. "PET and MRI of Prostate Cancer." Doctoral thesis, Uppsala universitet, Radiologi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-300940.
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Prostate cancer (PCa) is the most common non-skin malignancy of men in developed countries. In spite of treatment with curative intent up to 30-40% of patients have disease recurrence after treatment, resulting from any combination of lymphatic, hematogenous, or contiguous local spread. The concept of early detection of PCa offer benefits in terms of reduced mortality, but at the cost of over-diagnosis and overtreatment of indolent disease. This is largely due to the random nature of conventional biopsies, with a risk of missing significant cancer and randomly hitting indolent disease. In the present thesis, diagnostic performance of MRI DWI and 11C Acetate PET/CT lymph node staging of intermediate and high risk PCa, was investigated, and additionally, predictive factors of regional lymph node metastases were evaluated. Further, additional value of targeted biopsies to conventional biopsies, for detection of clinically significant PCa, was investigated. In paper one and two, 53 and 40 patients with predominantly high risk PCa underwent 11C Acetate PET/CT and 3T MRI DWI, respectively, for lymph node staging, before extended pelvic lymph node dissection (ePLND). The sensitivity and specificity for PET/CT was 38% and 96% respectively. The sensitivity and specificity for MRI DWI was 55% and 90% respectively. In paper three, 53 patients with newly diagnosed PCa were included. All patients underwent multi-parametric MRI, followed by two cognitive targeted biopsies. Five more clinically significant cancers were detected by adding targeted biopsies to conventional biopsies. In paper four the value of quantitative and qualitative MRI DWI and 11C Acetate PET/CT parameters, alone and in combination, in predicting regional lymph node metastases were examined. ADCmean in lymph nodes and T-stage on MRI were independent predictors of lymph node metastases in multiple logistic regression analysis. In conclusion the specificity of diffusion weighted MRI and 11C Acetate PET/CT for lymph node staging was high, although the sensitivity was low. Predictive factors of regional lymph node metastases could be retrieved from diffusion weighted MRI and 11C Acetate PET/CT. By combining targeted biopsies with conventional biopsies the detection rate of clinically significant PCa could be increased.
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Kao, Annie Sehsheng. "An epidemiological investigation of space-time clustering patterns and case-control study of risk factors for Kawasaki syndrome (KS) among children in San Diego County /." Diss., Connect to a 24 p. preview or request complete full text in PDF formate. Access restricted to UC campuses, 2005. http://wwwlib.umi.com/cr/ucsd/fullcit?p3190170.
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Peres, Gabriel. "Biópsia de linfonodo sentinela na recidiva locorregional do melanoma maligno revisão sistemática /." Botucatu, 2020. http://hdl.handle.net/11449/191662.
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Orientador: Antônio José Maria CataneoResumo: Introdução: No melanoma primário, a aplicabilidade da biópsia de linfonodo sentinela (BLS), seguida ou não de esvazimento linfonodal (EL) é conhecida. Na recidiva locorregional (RL) de melanoma, alguns serviços tendem a indicá-la, buscando estadiamento mais acurado para embasar condutas individualizadas aos pacientes, ainda que as evidências sejam insuficientes. Objetivo: Avaliar o sucesso da BLS no encontro do linfonodo sentinela (LNS) e sua positividade na RL. Comparar a sobrevida entre os pacientes com LNS positivo e negativo. Verificar diferença na sobrevida pós EL. Métodos: Revisão sistemática, através das bases MEDLINE via PUBMED, LILACS, SCOPUS, EMBASE e CENTRAL, buscando estudos experimentais e observacionais sobre BLS na RL de melanoma. Desfechos avaliados: sucesso na BLS pelo encontro do LNS, positividade para melanoma no LNS; sobrevida no subgrupo LNS positivo comparado com o negativo; sobrevida livre de doença no subgrupo LNS positivo comparada com o negativo; sobrevida dos pacientes submetidos ao EL. Para metanálises, utilizaram-se RevMan 5.3 e StatsDirect 3.0.121. Resultados: Foram identificados 1872 estudos, destes, seis estudos observacionais foram incluídos, totalizando 449 pacientes. O LNS foi encontrado em 98% das BLS (IC 95-100%, I2=53,7% - seis estudos). LNS com 32% de positividade para melanoma (IC 19-47%, I2= 84,6% - seis estudos). A chance de sobrevida global em cinco anos foi 2,49 vezes maior no subgrupo com LNS negativo (IC 95% 1,41-4,38, I2=0% - qua... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Background: In primary melanoma, the applicability of sentinel lymph node biopsy (SLB), followed or not by complete lymph node dissection (CLND) is known. In locoregional recurrence (LR) of melanoma, some groups may indicate it for more accurate staging to support individualized management, even with scarce evidence. Objective: To evaluate success in SLB and its positivity in LR. Compare survival between patients with positive and negative sentinel lymph node (SLN). Check for survival modification after CLND. Methods: Systematic review through databases such as MEDLINE via PUBMED, LILACS, SCOPUS, EMBASE and CENTRAL, searching for experimental and observational studies on SLB in melanoma LR. Outcomes assessed: success in SLB by finding the SLN, positivity for melanoma in the SLN; survival in the positive SLN subgroup compared to the negative one; disease-free survival in the positive versus negative SLN subgroup; survival of patients undergoing CLND. For meta-analyzes, RevMan 5.3 and StatsDirect 3.0.121 were used. Results: The total number of patients in six observational studies was 449, over 1872 studies indentified. The SNL was found in 98% of SLB (95-100% CI, I2 = 53.7%, 6 studies). SLB detected 32% positivity for melanoma on SNL (CI 19-47%, I2 = 84.6%, 6 studies). The chance of five year overall survival was 2,49 higher in the negative SNL subgroup (95% CI 1.41-4.38, I2 = 0%, 4 studies). Meta-analyzes were not performed due to lack of objective data for disease-free survi... (Complete abstract click electronic access below)
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Johnson, Laura. "Magnetic nanoparticles for sentinel lymph node imaging and biopsy in breast cancer." Thesis, King's College London (University of London), 2012. https://kclpure.kcl.ac.uk/portal/en/theses/magnetic-nanoparticles-for-sentinel-lymph-node-imaging-and-biopsy-in-breast-cancer(978692de-a495-4df1-ac0f-303227bed0dd).html.
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Background Axillary nodal status is the single most important prognostic factor in breast cancer diagnosis. If cancerous cells are present, the sentinel lymph node (SLN) is the axillary lymph node that is most likely to contain metastatic disease. In early stage breast cancer, the SLN is localised (then surgically removed for pathological analysis) using a radioisotope and/or a blue dye injected into the breast Super-paramagnetic iron oxide (SPIO) nanoparticles are novel agents that, when injected, could potentially both localise and characterise the SLN using MRI such that surgical SLN biopsy is no longer required. Aims To evaluate axillary SLN localisation after SPIO injection with, pre-operatively, axillary MRI and, intra-operatively, with a hand held magnetometer and to characterise SLN SPIO uptake using ex-vivo MRI. Methods From November 2009 - March 2011, 51 patients with early stage breast cancer underwent SLN biopsy following a subcutaneous injection of SPIO in addition to the standard injection of radioisotope (Tc99M) and blue dye. SPIO injection technique was refined during the trial with an initial dose of 2mls and then 4mls in 8 and then 43 women respectively. Pre-operative axillary in vivo MRI (1.5T) was carried out on 14 women and ex vivo high resolution MRI (9.4T) on 36 nodes. During surgery, an SLN was defined as either "hot", "blue", "palpable" or "SPIO detected". Axillary clearance was carried out for SLN-positive disease. Results In total, 11 of the 51 patients had positive SLNs. On pre-operative axillary MRI, SPIO uptake was noted in at least one node in all 14 patients. A total of 35 nodes were identified. Uptake of SPIO in the SLN was seen at a minimum of 12mins post injection. Involved SLNs were not differentiated from normal SLNs following morphological characterisation or based on loss of T2 signal within the individual SLN. At SLN biopsy, 134 hot, blue, palpable or SPIO-containing nodes were identified in 51 patients. The magnometer identified 92 SPIO-containing nodes in 51 (84%) patients. One node in one patient was not identified using the combined technique but was found to contain SPIO. Of the 16 hot, blue or palpable involved nodes in 11 patients, 9 contained SPIO. In summary, the SPIO SLN localisation rate and FNR in patients was 84% and 16% respectively. Ex vivo SLN MRI demonstrated SPIO uptake in all 35 SLNs preferential to the sinuses and sub-capsular spaces. Of the 3 involved nodes, areas of metastasis did not take up SPIO, whereas in normal areas of the node, SPIO was positively identified. Conclusion In our study, subcutaneous SPIO, a novel SLN-localising agent, was taken up by axillary nodes and identified on pre-operative axillary MRI. Node positive SLNs were identified on ex vivo MRI, but SPIO did not demonstrate sufficient accuracy at SLN localisation for routine clinical use.
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O'Sullivan, Jack Denis. "Imaging through a scanner, darkly : spectral imaging for sentinel lymph node biopsies." Thesis, University of Southampton, 2012. https://eprints.soton.ac.uk/339772/.
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Breast cancer is the single most prevalent form of cancer in the UK today, accounting for around 16% of all diagnoses, and around 31% of diagnoses in women. The survival rates are good, however the prognosis is heavily dependent on the stage to which the cancer has progressed at diagnosis. In order to help accurately determine this stage, the sentinel lymph node of patients undergoing tumour resection surgery is removed and examined cytologically for the presence of cancerous cells. This examination of the lymph node is currently the rate-limiting step in the operation as a whole. There is evidence in the literature to suggest that cancerous tissue has a measurably different infrared spectrum from healthy tissue owing to chemical and morphological differences in the tissue. There is further evidence to suggest that in the visible and near infrared region, the spectra of healthy lymph node tissue is different from that of cancerous tissue. This thesis details a project, performed in collaboration with a surgical team at St Mary's Hospital, Newport, Isle of Wight, to analyse spectral images taken in the visible and near infrared, of biopsied lymph node tissue. In the course of the project, an unsupervised classificaton technique, based on an extension to the well establised 'spectral angle', was developed to analyse the spectral images. Psoriasis affects 2-3% of the UK population causing itchy and/or painful plaques on the skin. One of the main treatments for psoriasis is UV phototherapy, exposure to which is a risk factor for burning and the development of cancers. This thesis details an investigation into the possibility of developing a targeted UV phototherapy system based on spectral imaging to delineate the plaques and a proposed new UV laser for treatment.
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Shimizu, Kenji. "Suppression of VEGFR-3 signaling inhibits lymph node metastasis in gastric cancer." Kyoto University, 2004. http://hdl.handle.net/2433/145281.
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Hassan, Hakki. "Morbidity of mediastinal lymph node dissection VS sampling treatment of lung cancer /." Bern : [s.n.], 1999. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.
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Dinh, Kate H. "Sentinel Lymph Node Biopsy in Elderly Patients with Intermediate Thickness Melanoma: A Masters Thesis." eScholarship@UMMS, 2015. https://escholarship.umassmed.edu/gsbs_diss/778.
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Background: A landmark study suggested that wide excision of intermediate-thickness melanoma with sentinel lymph node biopsy (SLNB) and subsequent completion lymph node dissection (CLND) for regional disease may improve prognostication and disease-free survival (DFS) compared with those undergoing wide excision alone. However, these benefits were relatively small and not associated with an improvement in disease-specific survival (DSS). It remains unknown if SLNB and subsequent treatments are beneficial in elderly patients who have a decreased overall (OS) due to other causes.
Methods: Adults ≥ 70 years of age, who underwent surgical intervention for intermediate-thickness cutaneous melanoma from 2000-2013 were identified from a prospectively-maintained database. Clinicopathologic variables measured included age, gender, anatomic site, histologic type, tumor thickness, ulceration, receipt and result of SLNB, completion of CLND, OS, and DFS.
Results: Ninety-one patients underwent excision of an intermediate-thickness melanoma. Forty-nine patients (54%) received a SLNB. Seven of these biopsies (14%) were positive, and five patients went on to receive CLND. Five-year OS was 41% in patients who did not receive SLNB and 52% in patients who did receive SLNB (p=0.11). DFS was similar between groups independent of receipt of SLNB.
Conclusion: Among elderly patients with intermediate-thickness melanoma, patients who received SLNB had similar 5-year OS and DFS compared with those who did not receive SLNB. Routine SLNB for intermediate-thickness melanoma patients may not significantly change outcomes for this age group, and clinical decision-making should consider individual patient comorbidities and goals of care.
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Dinh, Kate H. "Sentinel Lymph Node Biopsy in Elderly Patients with Intermediate Thickness Melanoma: A Masters Thesis." eScholarship@UMMS, 2005. http://escholarship.umassmed.edu/gsbs_diss/778.
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Background: A landmark study suggested that wide excision of intermediate-thickness melanoma with sentinel lymph node biopsy (SLNB) and subsequent completion lymph node dissection (CLND) for regional disease may improve prognostication and disease-free survival (DFS) compared with those undergoing wide excision alone. However, these benefits were relatively small and not associated with an improvement in disease-specific survival (DSS). It remains unknown if SLNB and subsequent treatments are beneficial in elderly patients who have a decreased overall (OS) due to other causes.
Methods: Adults ≥ 70 years of age, who underwent surgical intervention for intermediate-thickness cutaneous melanoma from 2000-2013 were identified from a prospectively-maintained database. Clinicopathologic variables measured included age, gender, anatomic site, histologic type, tumor thickness, ulceration, receipt and result of SLNB, completion of CLND, OS, and DFS.
Results: Ninety-one patients underwent excision of an intermediate-thickness melanoma. Forty-nine patients (54%) received a SLNB. Seven of these biopsies (14%) were positive, and five patients went on to receive CLND. Five-year OS was 41% in patients who did not receive SLNB and 52% in patients who did receive SLNB (p=0.11). DFS was similar between groups independent of receipt of SLNB.
Conclusion: Among elderly patients with intermediate-thickness melanoma, patients who received SLNB had similar 5-year OS and DFS compared with those who did not receive SLNB. Routine SLNB for intermediate-thickness melanoma patients may not significantly change outcomes for this age group, and clinical decision-making should consider individual patient comorbidities and goals of care.
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Uren, Roger. "Lymphatic mapping of the skin and breast: locating the sentinel node." Thesis, University of Sydney, 1999. https://hdl.handle.net/2123/27546.
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Lymphoscintigraphy has been used for many years to study the physiology of the lymphatic drainage of the skin. Following the intradermal injection of 99mTc antimony sulphide colloid images can be obtained using a gamma camera which display the pattern of lymphatic drainage from the injection site. When we first started performing the lymphatic mapping studies for patients of the Sydney Melanoma Unit we were using the study to clarify flow patterns in patients who had melanomas in skin sites which were considered on clinical grounds to have ambiguous lymphatic drainage. These were sites close to the midline of the trunk where drainage could occur to either axilla or sites close to a line drawn around the waist at the level of the umbilicus when drainage might occur to the axilla or groin. Sites on the head and neck were also included as drainage could occur to several different node fields. These clinical judgements were made based on the teachings of Sappey, a French physicians who had produced an elaborate atlas of the lymphatic drainage of the skin late in the 19th century. The imaging in each patient involved standard protocols which has been determined many years previously. In appropriate patients when lymphoscintigraphy had designed the pattern of lymphatic drainage an elective dissection of the node field was performed as part of the treatment of the patients melanoma. Our practice changed dramatically following the description of the sentinel node concept by Morton and colleagues.
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Fullwood, Leanne Marie. "Raman spectroscopy for rapid diagnosis of lymphomas and metastatic lesions found in lymph nodes." Thesis, University of Exeter, 2017. http://hdl.handle.net/10871/33140.
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At least 50% of people will develop cancer at some point during their lifetime and half these will end in fatality. Improving patients’ prognosis relies on early and accurate diagnosis and treatment. Current diagnostic methods are based on histopathological analysis and are time-consuming, expensive and require biopsy. Raman spectroscopy can measure subtle biochemical changes and provides a rapid, non-destructive and objective technique that can be used in vivo for identifying pathological changes in tissue samples. This study investigates both a standard Raman spectrometer system and also a Raman needle probe for their use as diagnostic techniques and clinical tools. Oesophageal, femoral and head and neck lymph nodes were analysed in this study. Metastatic lymph nodes from the three areas could be identified from the non-cancer lymph nodes with a sensitivity of 71% and specificity of 89%. Lymphoma was identified from non-cancer lymph nodes with a sensitivity of 64% and specificity of 86%. It was observed that oesophageal nodes often contained carbon particles, clinically diagnosed as anthracosis. These nodes were much harder to study than the femoral or head and neck, due to strong Raman signal detected from the carbon particles. Lymph nodes are embedded in adipose tissue and as a consequence, very strong lipid peaks were frequently observed in spectra. Spectral differences were exhibited in the measurements of the lymph nodes from the three different anatomical regions. A comparison of the point measurements and mapped data showed no difference in classification. Therefore, indicating that just a few measurements can be sufficient enough sampling to represent a specimen, and demonstrates the practicability of Raman use in vivo for rapid analysis. The Raman needle probe feasibility study showed its potential for in vivo use for real-time diagnosis and as a surgical tool to support biopsy. A sensitivity and specificity of 80% and 79% for the identification of non-cancer head and neck lymph nodes from non-cancer provides similar accuracies to the standard Raman approach, therefore supports its viability for use as a diagnostic tool.
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Lloyd, Shane. "A Prognostic Index for Predicting Lymph Node Metastasis in Minor Salivary Gland Cancer." Yale University, 2009. http://ymtdl.med.yale.edu/theses/available/etd-03052009-215912/.
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We hypothesized that lymph node involvement in minor salivary gland cancers is associated with clinical and pathological factors commonly available to the clinician after a typical initial workup. Our aim was to identify these factors using a dataset that allowed us to compile the largest series of minor salivary gland cancers in the published literature. Using this dataset we also aimed to characterize the distribution of histological types by primary site, identify the predictors of the use of external beam radiation therapy and neck dissection, and examine the effect of lymph node involvement on survival. Using the SEER database, we identified 2667 minor salivary gland cancers with known lymph node status from 1988 to 2004. Univariate and multivariate analyses were conducted to identify factors associated with the use of neck dissection, the use of external beam radiation therapy, and the presence of cervical lymph node metastases. Kaplan Meier survival curves were constructed to examine the effect of lymph node involvement on survival. 426 (16.0%) patients had neck nodal involvement. Factors associated with neck nodal involvement on univariate analysis included increasing age, male gender, increasing tumor size, high tumor grade, T3-T4 stage, adenocarcinoma or mucoepidermoid carcinomas, and pharyngeal site of primary malignancy. On multivariate analysis, four statistically significant factors were identified, which included male gender, T3-T4 stage, pharyngeal site of primary malignancy, and high-grade adenocarcinoma or high-grade mucoepidermoid carcinomas. The proportions (and 95% confidence intervals) of patients with lymph node involvement for those with 0, 1, 2, 3 and 4 of these prognostic factors were 0.02 (0.01-0.03), 0.09 (0.07-0.11), 0.17 (0.14-0.21), 0.41 (0.33-0.49), and 0.70 (0.54-0.85) respectively. Grade was a significant predictor of metastasis for adenocarcinoma and mucoepidermoid carcinoma but not for adenoid cystic carcinoma. Overall survival was significantly worse at 5, 10, and 15 years for patients with lymph node involvement on presentation. A prognostic index using the four clinicopathological factors listed above can effectively differentiate patients into risk groups of nodal metastasis. The precision of this index is subject to the limitations of SEER data and it should be validated in further clinical studies.
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Reed, Alison M. "The proliferative response of equine chondrocytes to bovine lymph node proteins in vitro." Connect to this title online, 2007. http://etd.lib.clemson.edu/documents/1181252094/.
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Teng, Chia-Chi. "Head and neck lymph node region delineation with automatic segmentation and image registration /." Thesis, Connect to this title online; UW restricted, 2007. http://hdl.handle.net/1773/6119.
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Baguet, Aurélie. "Rôle du gène Metastatic Lymph Node 51 dans le métabolisme des ARN messagers." Université Louis Pasteur (Strasbourg) (1971-2008), 2008. http://www.theses.fr/2008STR13090.
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Retter, Steffen Mario [Verfasser]. "Bewertung der Bedeutung des "Sentinel lymph node mapping" beim Kolonkarzinom / Steffen Mario Retter." Lübeck : Zentrale Hochschulbibliothek Lübeck, 2011. http://d-nb.info/1012010228/34.
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Chen, Chien-Sin [Verfasser], and Christoph [Akademischer Betreuer] Scheiermann. "Neural regulation of lymph node immune responses / Chien-Sin Chen ; Betreuer: Christoph Scheiermann." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2019. http://d-nb.info/1223369722/34.
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Hayes, Alan James. "Characterisation of cellular communication between an inflammatory site and the draining lymph node." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8160/.
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In order to track cell migration, the project used a transgenic mouse system which ubiquitously expressed the fluorescent protein kaede that undergoes photo-conversion when exposed to violet or ultraviolet (UV) light. By inducing inflammation in peripheral tissues (e.g. the ear pinna on the hind footpad) and subsequently exposing the tissue to UV light, it was possible to spatiotemporally track the fate of the cells at these tissue sites. The study revealed that tissue resident cells do not constitute the majority of the migratory population and that immune cells must first be recruited to the site of challenge prior to migration. Migration from the site of challenge to the draining lymph node occurs within the first 48 hours post injection and returns to baseline over the following 24 hours. By combining the above approach with the YAe/Eα system to track antigen presentation, the study has also shown that antigen presentation persists for the first 24-36 hours and the majority of cells presenting antigen are CD103+CD11b+ dendritic cells. In collaboration with UCB, CyTOF profiling was performed on the migratory population to identify the diversity of these cells, identifying CD4+ T cells, CD8+ T cells, γδ T cells, B cell and neutrophils in the draining lymph node originating from the injection site. Therefore, it is suggested that the migratory cells work in tandem with one another to control the initiation of adaptive immunity and determine the nature and the magnitude of the immune response. Additionally, the nature of an inflammatory stimulus can alter the magnitude and composition of the migratory population. This study highlights that our current knowledge regarding the initiation of adaptive immunity, in particular, the kinetics and phenotype of the migratory cells, remains limited. Further developing our understanding of the migratory population, antigen presentation and the kinetics of antigen presentation may help to identify new targets for immunomodulation for the treatment of inflammatory disorders or the development of new and improved vaccine adjuvants.
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Valente, Paulla Vasconcelos. "DescriÃÃo de tÃcnica cirÃrgica para abordagem da cadeia mamÃria interna em esternos isolados de cadÃver." Universidade Federal do CearÃ, 2008. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=1182.
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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel SuperiorTo identify the lymph node positioned along the internal mammary vessels in isolated sternum of human cadaver, to distinguish the number of lymph nodes at the second, third and forth intercostals spaces and to standardize the surgical approach to those nodes, in order to establish anatomical landmarks to be used with the current techniques of mammary gland sentinel lymph node detection. Ten sternum plates removed from unclaimed cadavers were used in this study. Sternal plates were removed using bilateral incisions of the ribs at the midclavicular lines. The characterization of the internal mammary vessels and the anatomical integrity of the parietal pleura were indispensable requirements during the procedure. The study was descriptive experimental. A total of 56 lymph nodes were removed from the second, third and forth intercostals spaces, being 30 at the right side and 26 ones at the left side. The second intercostal space was the one that shows the greatest number of lymph nodes in both sides. The lymph nodes of the chain of internal mammary vessels were dissected by a safe and practical technique, different from the one practiced by the Italian surgeons, pioneers at the dissection of the lymph nodes of the internal mammary vessels. The first stage of the dissection consisted of detaching the pectorals major muscle from its attachments to the manubrium and sternal body, exposing the sternocostal joints. Upon identification and detachment of the intercostals muscles approximately five cm from the ribs, special attention is paid to the neurovascular structures located at the superior border of the intercostal space, forming a window in a format of âUâ, exposing the internal mammary vessels and the lymph nodes to them related. The approach used is a reliable surgical technique for removing lymph node from sterna plates. The model is therefore valuable for breast surgeons training in sentinel node biopsy, an important procedure for breast cancer patients
Identificar os linfonodos localizados ao longo dos vasos mamÃrios internos em esternos isolados de cadÃveres, discriminar o nÃmero de linfonodos nos 2Â, 3Â e 4Â espaÃos intercostais e padronizar a abordagem cirÃrgica desses linfonodos, registrando os pontos de reparo a serem utilizados nas tÃcnicas atuais de pesquisa do linfonodo sentinela da mama. Estudaram-se dez esternos isolados de cadÃveres humanos. Os esternos foram obtidos atravÃs de secÃÃo bilateral do gradil costal ao nÃvel das linhas hemiclaviculares. A individualizaÃÃo e a integridade anatÃmica da pleura parietal e dos vasos mamÃrios internos foram requisitos imprescindÃveis durante a dissecÃÃo das peÃas. O estudo foi experimental descritivo. Um total de 56 linfonodos foram removidos dos 2Â, 3Â e 4Â espaÃos intercostais, sendo 30 Ã direita e 26 Ã esquerda. O 2Â espaÃo intercostal foi o que apresentou maior nÃmero de linfonodos nos lados direito e esquerdo. Os linfonodos da cadeia mamÃria interna foram abordados por uma tÃcnica segura, prÃtica e diferente da praticada pelos italianos, pioneiros na dissecÃÃo de linfonodos da cadeia mamÃria interna. Ocorre a divulsÃo do mÃsculo peitoral maior da sua inserÃÃo do manÃbrio e corpo do esterno, expondo as cartilagens esternocostais. Desinsere-se um segmento do mÃsculo intercostal de aproximadamente cinco cm a partir do bordo esternal de sua inserÃÃo no bordo superior da costela inferior do espaÃo intercostal, formando uma janela em âUâ, expondo assim os vasos mamÃrios internos e os linfonodos a eles relacionados. A abordagem cirÃrgica usada neste estudo demonstrou ser uma tÃcnica adequada para a exÃrese de linfonodos esternais. Conclui-se assim que o modelo utilizado se presta ao treinamento para o procedimento de biÃpsia de linfonodo sentinela, de grande valor na abordagem das pacientes portadoras de cÃncer de mama
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Snyman, Leon Cornelius. "Efficacy of the sentinel lymph node biopsy algorithm and PET/CT scan in assessing regional lymph node status in women with early stage endometrial and cervical cancer in a South African population." Thesis, University of Pretoria, 2017. http://hdl.handle.net/2263/64296.
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Abstract
Introduction
Knowledge about the oncologic status of pelvic lymph nodes forms an essential and integral part in the management of women with uterine cancer. Lymph node status is part of endometrial cancer staging and plays an important role in primary treatment and adjuvant treatment planning and prognosis in women with cervical cancer. Current practice in the management of uterine cancers involves systematic full pelvic lymphadenectomy, mainly to determine the oncological status of the nodes, as there is no high-quality evidence suggesting a therapeutic effect attributable to lymphadenectomy.
Imaging in the form of computed tomography (CT) scans and magnetic resonance (MRI) scan is not accurate to determine pelvic lymph node status in women with uterine cancer. Functional scans such as 18Fluoro-deoxy-glucose positron emission/computed tomography (FDG-PET/CT) scan might provide better access in this setting.
Sentinel lymph node biopsy (SLNB) procedures, specifically the SLNB algorithm, have been proposed as a safe and accurate alternative procedure to full systematic lymphadenectomy in women with uterine cancers. It has also been proposed as a better alternative than complete omission of lymphadenectomy in women with presumed low risk early stage endometrial cancer. SLNB procedures might also be able to detect higher rates of lymph node metastases with the detection of micro metastases following pathological ultrastaging
The presence or absence of high risk human papilloma virus (hrHPV) DNA in sentinel lymph nodes of women with cervical cancer has also been suggested to be a useful adjunct to frozen section examination (FSE) in assisting with determination of the status of the non-sentinel nodes. Some data suggest the combination of negative FSE and absence of hrHPV accurately predict the absence of metastases.
South African women have high prevalence of human immunodeficiency virus infection, tuberculosis (TB) and pelvic inflammatory disease (PID). All these infections involve the lymphatic system. Data on SLNB procedures are form well-developed countries with different disease burdens and socioeconomic profiles, and there is no data from women living in low-resource settings.
Aims
This study aimed to determine the efficacy of and performance of FDG-PET/CT scan and SLNB and SLNB algorithm in accurately predicting the regional lymph node status of the pelvis in women with early stage cervical cancer and presumed early stage endometrial cancer. It also aimed to investigate the usefulness of HPV DNA testing of sentinel nodes in women with cervical cancer.
Population and setting
This was a prospective observational study performed in the Gynaecologic Oncology Unit at the Kalafong Provincial Tertiary Hospital and Steve Biko Academic Hospital.
Patients aged 18 years and older, with operable stages cervical cancer and presumed early stage endometrial cancer willing and able to provide informed consent were eligible for inclusion.
Materials and methods
Sentinel node mapping was done using methylene blue (MB) and indocyanine green (ICG) injected into the cervix after induction of anaesthesia at the time of primary surgery. 99Technetium nanocolloid (99Tc) was administered one day pre-operatively followed by lymphoscintigram. FDG-PET/CT scans were performed prior to surgery.
Following mapping and removal, FSE, HPV DNA typing, haematoxylin and eosin (H&E) examination with ultrastaging on H&E negative specimens were performed on the SLNs. All patients underwent systematic full pelvic lymphadenectomy and appropriate cancer surgery.
Results
One hundred patients were prospectively recruited to the study and results of 94 patients were available for analysis. SNL detection rate of the whole group was 60.6% with bilateral detection 29.2%. Twenty-four patients (25.5%) had pelvic metastases.
Sixty-five percent of women with cervical cancer in this study were HIV positive, and the SLN detection rate in this group was 65% with bilateral detection rate of 30%. The detection rate was significantly higher in women without nodal metastases, those with stage IA2 – IB2 disease, with tumour less than 2 cm and women with BMI less than 25 kg/m2. HIV status, history of TB, PID and the presence of adhesions did not influence the SLN detection rate. The sentinel lymph node biopsy algorithm has a sensitivity of 100%, NPV of 100% and a false negative rate of 0% in this study. The SLNB procedure identified two women with only micro metastases (15.4%). These women would not have been identified with systematic lymphadenectomy and H&E examination.
Indocyanine green and the combination of methylene blue and 99Technetium nanocolloid had significantly better sentinel node detection rates compared to methylene blue alone
FDG-PET/CT scan was performed in 28 women. The sensitivity, specificity, positive and negative predictive values of FDG-PET/CT scans to accurately predict nodal status, were 66.67%, 82%, 30.77% and 95.38% respectively. The false negative rate of FDG-PET/CT scans was 33.3%.
The sensitivity, specificity, PPV and NPV for FSE in this cohort was 66.67%, 100%, 100% and 96.05% respectively. The FNR for FSE was 23.1%.
Thirty-two patients with cervical cancer had tumour and SLN hrHPV DNA data. The sensitivity, specificity, PPV and NPV of sentinel lymph node HPV DNA to predict metastases was 50%, 69.6%, 30 and 84.2% respectively with a false negative rate of 42.8%.
Conclusions
Although the SLN detection rate was lower compared to the published literature, the SLNB algorithm performed excellently in this group of patients of which the majority were HIV-infected.
The SLNB procedure can be considered as a treatment option in selected cases in the management of women with early stage endometrial and cervical cancer.
PET/CT should not be used as part of the primary diagnosis and staging investigations in women with uterine cancer, and is recommended only in selected cases for initial staging of locally advanced cervical cancer being considered for radical chemoradiation therapy.
In this study, testing for the presence of hrHPV DNA in the sentinel lymph nodes was not useful as a predictor of pelvic lymph node status. The combination of negative FSE and negative hrHPV in the SLNs did not have a reliable negative predictive value for the absence of pelvic nodal metastases.Thesis (PhD)--University of Pretoria, 2017.
Obstetrics and Gynaecology
PhD
Unrestricted
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Sethi, Neeraj. "Molecular profiling of primary head and neck squamous cell carcinoma and lymph node metastases." Thesis, University of Leeds, 2015. http://etheses.whiterose.ac.uk/13416/.
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INTRODUCTION: The presence of lymph node metastases and/or extracapsular spread (ECS) has a significant impact on patient survival in Head and neck squamous cell carcinoma (HNSCC). Little is known about the molecular mechanisms associated with metastasis. A marker that could predict metastasis from primary tumour sampling could be of great clinical benefit for patients. Similarly in oropharyngeal squamous cell carcinoma (OPSCC), the molecular changes associated with human papilloma virus are incompletely understood. The impact of viral load has not been well explored and could help identify molecular markers associated with Human papillomavirus (HPV)-driven OPSCC. METHODS: Tissue samples were identified from Leeds Pathology Archive and nucleic acid extracted from these. This was processed into sequencing libraries and analysed for copy number alteration (CNA) and microRNA (miRNA) profiles in clinicopathologic groups relating to metastasis and HPV viral load. RESULTS: A panel of 14 CNAs was identified as associated with nodal metastasis and loss of 18q21.1-q21.32 was associated with ECS. The fraction of genome altered (FGA) was also increased in metastatic primary tumours. A panel of 19 CNAs was identified as associated with no detectable viral load and the FGA was found to be increased in this group of OPSCC. Twelve miRNAs were identified as associated with nodal metastasis. DISCUSSION: The CNA and miRNA profile of primary tumours was found to be largely similar, though not identical, highlighting the need to use metastatic tissue to attempt discovery of metastatic molecular markers. Integrating miRNA and CNA data suggested miRNA expression is not governed by CNA. Potentially translational marker for metastasis and OPSCC with no viral load have been identified.
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Chen, Keguan. "Identification of functionally distinct lymph node stromal cells with breast carcinoma growth-promoting activity." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ37104.pdf.
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Perera, Rushika. "Genome wide identification of target genes associated with lymph node metastasis in Esophageal Adenocarcinoma." Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=107901.
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Esophageal cancer (EC) is one of the world's deadliest malignancies. Despite technological advancements in surgery and other therapies, the 5-year survival rate is less than 30%. Due to the lack of reliable diagnostic markers, EC remains an aggressive disease capable of forming secondary tumours in many locations including lymph nodes (LNs). In fact, over 80% of esophageal cancer patients have LN metastasis and the presence of LN metastasis at surgery is one of the greatest predictors of poor survival outcome. The goal of this study was to identify genes associated with the metastatic dissemination of cancer cells from a primary tumour to a regional LN. This could help us understand the mechanisms of LN metastasis and potentially provide therapeutic targets to manage this deadly disease. Laser Capture Microdissection (LCM) was used to obtain pure populations of cancer cells in matched primary tumour and LN metastases from chemo and radiotherapy naïve patients with adenocarcinoma (ADC) of the esophagus. Differences in whole genome expression patterns between primary tumour and LNs were analyzed using cDNA microarrays. Genes involving TNF, NFKβ, Wnt pathways and those associated with immune response have been identified as potential key players in promoting metastasis. Many of these genes are primarily involved in cellular processes such as cellular proliferation, cell migration and cell adhesion. These finding suggest that LN metastasis in esophageal ADC may arise from changes in a cancer cell's ability to interact with new microenvironments and effectively deal with the host's immune system.Le cancer de l'oesophage (CaO) est une des malignités les plus mortelles connues. Malgré de nombreux avancements de la médecine moderne dans les domaines de la chirurgie et autres thérapies, le pourcentage des gens survivant cinq ans est de moins de 30 %. En raison du manque de marqueurs de diagnostique fiables, le CaO reste une maladie agressive capable de causer la formation de tumeurs secondaires à plusieurs emplacements, dont les ganglions lymphatiques (GL). En fait, plus de 80 % des patients atteints de CaO présentent des tumeurs métastatiques au GL lors de la chirurgie, constituant un indice des plus déterminant dans un pronostique pessimiste. Le but de cette étude était d'identifier les gènes associés à la dissémination métastatique des cellules cancéreuses à partir d'une tumeur primaire vers un GL local. Cette identification des gènes déterminants pourrait s'avérer être cruciale dans la compréhension du mécanisme de métastase au niveau des GL et potentiellement aider à la mise sur pied de soins actifs plus efficaces dans le traitement de cette maladie dévastatrice. La Microdissection au Laser (ML) est utilisée pour l'obtention de populations pures de cellules cancéreuses. La ML est utilisée pour effectuer des prélèvements dans la tumeur primaire ou au niveau des métastases des GL à partir de patients avec adénocarcinome (ADC) de l'oesophage n'ayant pas reçu de chimio et radiothérapie. Les différences dans l'expression du génome entier entre la tumeur primaire et les GL ont été analysées à l'aide d'une puce à ADN microarray. Les gènes incluant les voies métaboliques TNF, NFKβ,Wnt et celles associées avec une réaction immunitaire ont été identifiés en tant que joueurs clés provoquant la métastase. Plusieurs de ces gènes sont impliqués dans les procédés cellulaires tels la prolifération, migration et adhésion cellulaire. Ces constatations suggèrent que les métastases aux GL dans les ADC oesophagiens surviendraient suite à des changements au niveau de l'habileté d'une cellule cancéreuse à interagir avec de nouveaux microenvironnements et efficacement trafiquer le système immunitaire de l'hôte.