前哨淋巴结（SN）概念对癌症手术具有重大影响。我们的目的是检查树突状细胞 (DC) 和巨噬细胞的哪种形态对应于 SN 对抗癌症的“预处理”。尽管巨噬细胞通常能够耐受癌症转移，但 CD169 阳性亚型被认为是有限的例外。采用免疫组织化学和形态计量学分析检查 23 例伴有或不伴有淋巴结转移的胃癌患者的 SN 和非 SN 中的 DC-SIGN、CD68 和 CD169 阳性细胞。所有患者均存活>5年且无复发。 DC存在于被膜下、副皮质和髓窦中，其内皮细胞表达DC-SIGN和平滑肌肌动蛋白（SMA）。在无转移患者的非 SN 中，包膜下 DC 比 SN 占据更大的面积，并且这种差异具有统计学意义。相反，被膜下 DC 可能已迁移至 SN 的副皮质区域。 DC簇通常与巨噬细胞簇重叠；然而，CD169阴性巨噬细胞的组织细胞增生症样簇显示出较小的重叠。我们发现 SN 中的 DC-SIGN 和 CD169 阳性簇之间的重叠明显大于非 SN 中的重叠；较大的重叠似乎对应于这些细胞群之间癌症抗原的较高交叉呈递。 DC-SIGN-CD169-双阳性细胞可能存在于该重叠区域内。胃癌中的 SN 通常被预先调节为癌症免疫的前沿，但有时它们可​​能比非 SN 更早被抑制。 DC-SIGN 和 CD169 阳性细胞似乎有所减少，原因是距原发灶发生的时间较长且距转移灶的距离较短。© 2024 作者。约翰·威利出版的《解剖学杂志》

The sentinel lymph node (SN) concept has a significant impact on cancer surgery. We aimed to examine which morphology of dendritic cells (DCs) and macrophages corresponds to "preconditioning" of the SN against cancer. Although macrophages are generally able to tolerate cancer metastasis, the CD169-positive subtype is believed to be a limited exception. Immunohistochemical and morphometric analyses were performed to examine DC-SIGN-, CD68-, and CD169-positive cells in SNs and non-SNs of 23 patients with gastric cancer with or without nodal metastasis. All patients survived for >5 years without recurrence. DCs were present in the subcapsular, paracortical, and medullary sinuses, the endothelia of which expressed DC-SIGN and smooth muscle actin (SMA). In the non-SNs of patients without metastasis, subcapsular DCs occupied a larger area than SNs, and this difference was statistically significant. Conversely, subcapsular DCs were likely to have migrated to the paracortical area of the SNs. DC clusters often overlapped with macrophage clusters; however, histiocytosis-like clusters of CD169-negative macrophages showed a smaller overlap. We found a significantly larger overlap between DC-SIGN and CD169-positive clusters in SNs than in non-SNs; the larger overlap seemed to correspond to a higher cross-presentation of cancer antigens between these cell populations. DC-SIGN-CD169-double positive cells might exist within this overlap. SNs in gastric cancers are usually preconditioned as a frontier of cancer immunity, but they may sometimes be suppressed earlier than non-SNs. DC-SIGN- and CD169-positive cells appeared to decrease owing to a long lag time from the primary lesion occurrence and a short distance from the metastasis.© 2024 The Author(s). Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.