癌症扩散至淋巴结 (LN) 与预后较差、远处转移发生率增加以及治疗反应降低有关。液氮微环境对癌细胞施加选择性压力，创造出可以在液氮中存活的细胞，并为远处转移扩散提供生存优势。此外，癌细胞的存在会导致免疫抑制性淋巴结微环境，有利于逃避抗癌免疫监视。然而，最近的研究还揭示了肿瘤引流淋巴结 (TDLN) 在癌症免疫治疗反应中以前未被认识的作用，包括充当预先耗尽的 CD8 T 细胞和干细胞样 CD8 T 细胞的储存库。在这篇综述中，我们将讨论癌细胞通过淋巴系统的扩散、TDLN 在转移和抗癌免疫反应中的作用，以及针对 LN 转移的治疗机遇和挑战。版权所有 © 2024 Lei, Fraser, Jones,乌贝拉克和帕德拉。

Cancer dissemination to lymph nodes (LN) is associated with a worse prognosis, increased incidence of distant metastases and reduced response to therapy. The LN microenvironment puts selective pressure on cancer cells, creating cells that can survive in LN as well as providing survival advantages for distant metastatic spread. Additionally, the presence of cancer cells leads to an immunosuppressive LN microenvironment, favoring the evasion of anti-cancer immune surveillance. However, recent studies have also characterized previously unrecognized roles for tumor-draining lymph nodes (TDLNs) in cancer immunotherapy response, including acting as a reservoir for pre-exhausted CD8+ T cells and stem-like CD8+ T cells. In this review, we will discuss the spread of cancer cells through the lymphatic system, the roles of TDLNs in metastasis and anti-cancer immune responses, and the therapeutic opportunities and challenges in targeting LN metastasis.Copyright © 2024 Lei, Fraser, Jones, Ubellacker and Padera.