A study on the correlation between plasmacytoid dendritic cells and lymph node metastasis in advanced gastric cancer

doi:10.19401/j.cnki.1007-3639.2025.08.008

Abstract

Abstract:

Background and purpose: Plasmacytoid dendritic cells are one of the key immune cells in the tumor microenvironment (TME), which can directly or indirectly regulate tumor related immune responses and play multiple roles in the development and metastasis of tumors. This study aimed to investigate the correlation between plasmacytoid dendritic cells in lymph nodes and lymph node metastasis in patients with advanced gastric cancer. Methods: Postoperative lymph node tissue specimens and clinicopathological data from advanced gastric cancer patients who underwent D2 radical surgery in the Department of General Surgery at the First Hospital of Dandong were gathered from January 2019 to December 2023. The lymph nodes were grouped based on pTNM staging and the diameter of metastatic lesions. This study was approved by the Medical Ethics Committee of Dandong First Hospital (No. DDSDYYY-LLSC-2025-02-18-019-01), and all patients signed informed consents. Immunohistochemical staining was used to detect the expression levels of CD123-positive plasmacytoid dendritic cells in different lymph node groups, and their correlation with lymph node metastasis in advanced gastric cancer was further analyzed. Results: Of the 116 patients, plasmacytoid dendritic cells infiltrate the lymph node tissues of gastric cancer patients. As tumor differentiation decreased and pT stage, pathological stage, lymphatic/vascular invasion, and perineural invasion increased, the mean number of CD123-positive pDC in metastatic lymph nodes rose significantly (P<0.05). The number of CD123-positive plasmacytoid dendritic cells was higher in metastatic lymph node-positive tissues than in metastatic lymph node-negative tissues, the number was higher in the macrometastasis group of pN1-3 staging than in the micrometastasis group, and the number was higher in the non-metastatic lymph node group of pN1-3 staging than in the pN0 staging lymph node group (P<0.05). In lymph node metastasis-positive cases, the number of CD123-positive plasmacytoid dendritic cells was higher in second-station lymph nodes than in first-station lymph nodes (P<0.05). Conclusion: The infiltration of CD123-positive plasmacytoid dendritic cells in lymph nodes of patients with advanced gastric cancer is closely associated with lymph node metastasis and may serve as a prerequisite for metastatic spread. Understanding the distribution of CD123-positive plasmacytoid dendritic cells in gastric cancer lymph nodes can help further explore their role in the immune microenvironment of gastric cancer. Targeted therapy focusing on CD123-positive plasmacytoid dendritic cells may become a new strategy for the treatment of advanced gastric cancer.

Key words: Plasmacytoid dendritic cell, CD123, Advanced gastric cancer, Lymph node metastasis, pTNM staging

CLC Number:

R735.2

CHEN Zhanwei, WU Yaoqiang, WANG Yanping, ZHANG Dejian, YU Fuxiang. A study on the correlation between plasmacytoid dendritic cells and lymph node metastasis in advanced gastric cancer[J]. China Oncology, 2025, 35(8): 792-798.

Figures/Tables 6

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Clinical characteristics	Number of cases	Group A (n=44)	Group B (n=72)	χ² value	P value
Gender
Male	78	28 (35.9)	50 (64.1)	0.418	0.518
Female	38	16 (42.1)	22 (57.9)
Age/year
≥65	74	30 (40.5)	44 (59.5)	0.591	0.442
<65	42	14 (33.3)	28 (66.7)
Tumor diameter/cm
≥5	60	16 (26.7)	44 (73.3)	6.698	0.010
<5	56	28 (50.0)	28 (50.0)
Degree of differentiation
Well + moderately	50	27 (54.0)	23 (46.0)	9.638	0.002
Poorly	66	17 (25.8)	49 (74.2)
Vascular invasion
+	58	2 (3.4)	56 (96.6)	-	0.001
-	58	42 (72.4)	16 (27.6)
Perineural invasion
+	32	0 (0.0)	32 (100.0)	-	0.001
-	84	44 (52.4)	40 (47.6)
pT stage
T1+T2	41	24 (58.5)	17 (41.5)	11.436	0.001
T3+T4	75	20 (26.7)	55 (73.3)
Pathological staging
Ⅰ+Ⅱ	66	44 (66.7)	22 (33.3)	-	0.001
Ⅲ+Ⅳ	50	0 (0.0)	50 (100.0)

Clinical characteristics	Number of cases	Number of pDCs	t/t’	P value
Gender
Male	52	43.45±6..62	1.361	0.178
Female	20	45.72±5.48
Age/year
≥65	46	43.67±6.58	0.557	0.579
<65	26	44.56±6.07
Tumor diameter/cm
≥5	14	43.54±6.82	0.840	0.404
<5	58	45.07±5.70
Degree of differentiation
Well+moderatel	23	40.17±5.72	3.784	0.001
Poorly	49	45.83±6.53
Vascular invasion
+	56	45.73±6.31	5.784	0.001
-	16	36.19±4.47
Perineural invasion
+	32	47.56±5.73	4.983	0.001
-	40	40.82±5.72
pT stage
T1+T2	17	35.44±2.85	8.283	0.001
T3+T4	55	45.70±5.96
Pathological staging
Ⅰ+Ⅱ	22	35.68±3.18	9.127	0.001
Ⅲ+Ⅳ	50	46.38±5.14