The lymph node is a structurally complex organ of the immune system, whose dynamic cellular arrangements are thought to control much of human health. Currently, no methods exist to precisely stimulate substructures within the lymph node or analyze local stimulus-response behaviors, making it difficult to rationally design therapies for inflammatory disease. Here we describe a novel integration of live lymph node slices with a microfluidic system for local stimulation. Slices maintained the cellular organization of the lymph node while making its core experimentally accessible. The 3-layer polydimethylsiloxane device consisted of a perfusion chamber stacked atop stimulation ports fed by underlying microfluidic channels. Fluorescent dextrans similar in size to common proteins, 40 and 70 kDa, were delivered to live lymph node slices with 284 ± 9 μm and 202 ± 15 μm spatial resolution, respectively, after 5 s, which is sufficient to target functional zones of the lymph node. The spread and quantity of stimulation were controlled by varying the flow rates of delivery; these were predictable using a computational model of isotropic diffusion and convection through the tissue. Delivery to two separate regions simultaneously was demonstrated, to mimic complex intercellular signaling. Delivery of a model therapeutic, glucose-conjugated albumin, to specific regions of the lymph node indicated that retention of the drug was greater in the B-cell zone than in the T-cell zone. Together, this work provides a novel platform, the lymph node slice-on-a-chip, to target and study local events in the lymph node and to inform the development of new immunotherapeutics.
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http://dx.doi.org/10.1039/c6an02042a | DOI Listing |
Ann Surg Oncol
January 2025
Department of Gastroenterology and Hepatology, Isala, Zwolle, The Netherlands.
Background: Similar to T1 colon cancer (CC), risk stratification may guide T2 CC treatment and reduce unnecessary major surgery. In this study, prediction models were developed that could identify T2 CC patients with a lower risk of lymph node metastasis (LNM) for whom (intensive) follow-up after local treatment could be considered.
Methods: A nationwide cohort study was performed involving pT2 CC patients who underwent surgery between 2012 and 2020, using data from the Dutch ColoRectal Audit, which were linked to the Nationwide Pathology Databank.
Tech Coloproctol
January 2025
Department of Surgery, Amsterdam UMC Location Vrije Universiteit, Amsterdam, The Netherlands.
Since the adoption of neoadjuvant chemoradiation and total mesorectal excision as the standard in rectal cancer care, there has been marked improvement in the local recurrence rates. In this context, restaging magnetic resonance imaging (MRI) plays a key role in the assessment of tumor response, occasionally enabling organ-sparing approaches. However, the role of restaging MRI in evaluating lateral lymph nodes remains limited.
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January 2025
Department of Colorectal Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpodearo, Seochogu, Seoul, 06591, Korea.
Metastatic lateral pelvic lymph node (LPN) in rectal cancer has a significant clinical impact on the prognosis and treatment strategies. But there are still debates regarding prediction of lateral pelvic lymph node metastasis and its oncological impact. This review explores the evidence for predicting lateral pelvic lymph node metastasis and survival in locally advanced rectal cancer.
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January 2025
Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Lateral lymph node dissection (LLND) is getting global attention as an a surgical option to reduce local recurrence in locally advanced rectal cancer. As the transanal total mesorectal excision (TaTME) is gaining popularity worldwide, a novel LLND approach was established adopting a two-team approach that combines the transabdominal and transanal approaches using the TaTME technique. This narrative review describes the advantages, anatomical landmarks, surgical techniques, and pitfalls of transanal LLND (TaLLND).
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January 2025
Colorectal Unit, Department of Surgery, Royal Adelaide Hospital, Port Road, SA, 5000, Australia.
Lateral pelvic lymph node dissection (LPLND) for rectal adenocarcinoma is an established treatment modality for selected patients with abnormal lateral pelvic lymph nodes on magnetic resonance imaging (MRI) imaging. The goal of this treatment is to achieve a true R0 resection, including lymphadenectomy, with the aim of improving patient oncological outcome, potentially at the expense of surgical and functional complications. However, there remain several areas of controversy resulting from a distinct lack of clarity regarding effective patient selection, lymph node size criteria, the role and extent of routine neoadjuvant treatment versus surgery alone in selected cases, the impact on patient survival metrics and whether the existing data are even valid in the era of total neoadjuvant therapy (TNT).
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