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Reversal of Immune Suppression in Sentinel Lymph Nodes

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From Local Invasion to Metastatic Cancer

Part of the book series: Current Clinical Oncology ((CCO))

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Abstract

Minimally invasive intraoperative lymphatic mapping and sentinel node biopsy (LM/SNB) has become the standard approach for staging the regional lymph nodes for early-stage melanoma and breast cancer and has potential applications in other malignancies. The procedure requires close collaboration of surgeon, pathologist, and nuclear medicine physician. The strength of LM/SNB is its accuracy of detecting occult lymph node metastases while the therapeutic value of early dissection of occult metastases is yet unproved. RT-PCR analyses of either fresh frozen or paraffin-embedded sections of the sentinel lymph nodes may be more sensitive than hematoxylin and eosin (H&E) or immunohistochemistry but lack the specificity compared to conventional methods and limits in the availability of tissue specimens make RT-PCR impractical for routine use. LM/SNB allows for focused analysis of the matched primary malignancy and sentinel node. Research from human melanoma specimens suggest the sentinel node (SN) has molecular properties pointing toward immune dysfunction of these lymph nodes as compared with adjacent non-SNs and that reversal of this dysfunction may be an effective method of enhancing the immune response to melanoma.

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Authors and Affiliations

  1. Departments of Surgical Oncology and Molecular Therapeutics, California Oncology Research Institute, Santa Monica, CA and the University of California, Los Angeles, CA, USA

    Richard Essner MD

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  1. Richard Essner MD
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Editors and Affiliations

  1. Division of Surgical Oncology, University of California, San Francisco, Divisadero St. 1600, San Francisco, 94115, USA

    Stanley P. L. Leong

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Essner, R. (2009). Reversal of Immune Suppression in Sentinel Lymph Nodes. In: Leong, S. (eds) From Local Invasion to Metastatic Cancer. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-087-8_35

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  • DOI: https://doi.org/10.1007/978-1-60327-087-8_35

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