PDF(Pubmed)
Abstract：
Neck dissection for cervical lymph node metastasis is an established procedure for head and neck cancer (HNC). However, with the advent of immunotherapy, head and neck surgical oncologists need to rethink removing all lymph nodes, including those with immune function. We investigated the anti-cancer immune response of the cervical lymph nodes in four patients with human papillomavirus type 16 (HPV16)-positive head and neck squamous cell carcinoma. Using lymphocytes extracted from local, metastatic, and non-metastatic lymph nodes and peripheral blood from these patients, we performed an intracellular flow cytometric cytokine assay using anti-IFNγ and anti-TNF-α monoclonal antibodies to detect HPV16 E6- and E7-specific T cells. HPV status and p16 immunostaining were determined by in situ detection using the HPV RNAscope method and immunohistochemistry. In one case, E6-specific and E7-specific CD8+ T cells were detected in proximal metastatic nodes and distal non-metastatic nodes. This finding suggests that non-metastatic nodes should be preserved for their immune function during neck dissection and that the immune function of non-metastatic lymph nodes is important when administering immunotherapy. In this context, head and neck surgical oncologists treating HNC should consider the place of immunotherapy and neck dissection in the treatment of HNC.
摘要：
颈部淋巴结转移的颈部清扫是头颈部癌（HNC）的既定程序。然而,随着免疫疗法的出现，头颈外科肿瘤学家需要重新考虑去除所有淋巴结，包括那些有免疫功能的人。我们调查了4例人乳头瘤病毒16型（HPV16）阳性头颈部鳞状细胞癌患者的颈淋巴结的抗癌免疫反应。使用从局部提取的淋巴细胞，转移性，这些患者的非转移性淋巴结和外周血，我们使用抗IFNγ和抗TNF-α单克隆抗体进行了细胞内流式细胞术细胞因子测定,以检测HPV16E6和E7特异性T细胞.HPV状态和p16免疫染色通过使用HPVRNAscope方法和免疫组织化学的原位检测来确定。在一个案例中,在近端转移淋巴结和远端非转移淋巴结中检测到E6特异性和E7特异性CD8+T细胞。这一发现表明，非转移性淋巴结应在颈部淋巴结清扫术中保留其免疫功能，而非转移性淋巴结的免疫功能在施用免疫疗法时很重要。在这种情况下，治疗HNC的头颈外科肿瘤学家应考虑免疫治疗和颈清扫术在治疗HNC中的地位。
