title: Analysis of T-helper type 1 and 2 cells and T-cytotoxic type 1 and 2 cells of sentinel lymph nodes in breast cancer.
abstract: The immune suppression of sentinel lymph node (SN) is directly influenced by primary tumors. It has been reported that the T-helper type 1 (Th1) to T-helper type 2 (Th2) ratio or T-cytotoxic type 1 (Tc1) to T-cytotoxic type 2 (Tc2) ratio of lymph node lymphocytes could be used to evaluate direct immunological circumstances. We attempted to evaluate the Th1 to Th2 cell and Tc1 to Tc2 cell balance in SN and non-SN and to clarify the immunological status of sentinel nodes in breast cancer. To evaluate this balance, SN and non-SN were identified by radioguided methods and lymph node lymphocytes were collected, and prepared for flow cytometry. The Th1 to Th2 and Tc1 to Tc2 ratio were calculated by 3-color flow cytometry. The ratio of SN and non-SN was compared. The results demonstrated that SN was detected in 24 out of 24 patients (100%). As regards the correlation between SN and non-SN in the same patients, the Th1 to Th2 ratio in SN was significantly lower than that in non-SN for all patients (p<0.05). Among clinicopathological factors, a larger tumor diameter, histology and nodal involvement affected the decreased Th1 to Th2 ratio in SN significantly (p<0.05). We reached the conclusion that the increasing immunosuppressive conditions derived from the tumor may deteriorate the Th1 to Th2 ratio of SN in an earlier stage as compared with non-SN. According to the tumor extension and nodal involvement, the Th1 to Th2 ratio in SN was significantly suppressed. The current result supports that mainly helper T-cell paralysis occurred first in SN and this seems to be a favorable condition in forming lymph node metastases in SN. Moreover, the immunologic interaction between the primary site and regional lymph nodes may serve as useful criteria for identifying sentinel nodes.
authors.affiliation: Digestive Surgery Surgical Oncology, Kagoshima University School of Medicine, Kagoshima 890-8520, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Ehi
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.forename: Izumi
authors.initials: I
authors.lastname: Masamoto
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Uenosono
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
authors.forename: Takaaki
authors.initials: T
authors.lastname: Arigami
authors.forename: Hideo
authors.initials: H
authors.lastname: Arima
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kijima
authors.forename: Heiji
authors.initials: H
authors.lastname: Yoshinaka
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Yanagita
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kozono
authors.forename: Yawara
authors.initials: Y
authors.lastname: Funasako
authors.forename: Ikuro
authors.initials: I
authors.lastname: Maruyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Aikou
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000276:immunology*; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy; D016176:T-Lymphocyte Subsets / Q000276:immunology; D013602:T-Lymphocytes, Cytotoxic / Q000145:classification / Q000276:immunology*; D018417:Th1 Cells / Q000276:immunology*; D018418:Th2 Cells / Q000276:immunology*