Mapping the spreading routes of lymphatic metastases in human colorectal cancer

Chong Zhang, Lin Zhang, Tianlei Xu, Ruidong Xue, Liang Yu, Yuelu Zhu, Yunlong Wu, Qingqing Zhang, Dongdong Li, Shuohao Shen, Dongfeng Tan, Fan Bai () and Haizeng Zhang ()
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Chong Zhang: Peking University
Lin Zhang: Chinese Academy of Medical Sciences and Peking Union Medical College
Tianlei Xu: Chinese Academy of Medical Sciences and Peking Union Medical College
Ruidong Xue: Peking University
Liang Yu: Chinese Academy of Medical Sciences and Peking Union Medical College
Yuelu Zhu: National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
Yunlong Wu: Chinese Academy of Medical Sciences and Peking Union Medical College
Qingqing Zhang: Chinese Academy of Medical Sciences and Peking Union Medical College
Dongdong Li: Chinese Academy of Medical Sciences and Peking Union Medical College
Shuohao Shen: Chinese Academy of Medical Sciences and Peking Union Medical College
Dongfeng Tan: The University of Texas M. D. Anderson Cancer Center
Fan Bai: Peking University
Haizeng Zhang: Chinese Academy of Medical Sciences and Peking Union Medical College

Nature Communications, 2020, vol. 11, issue 1, 1-11

Abstract: Abstract Lymphatic metastases are closely associated with tumor relapse and reduced survival in colorectal cancer (CRC). How tumor cells disseminate within the lymphatic network remains largely unknown. Here, we analyze the subclonal structure of 94 tumor samples, covering the primary tumors, lymph node metastases (LNMs), and liver metastases from 10 CRC patients. We portray a high-resolution lymphatic metastatic map for CRC by dividing LNMs into paracolic, intermediate, and central subgroups. Among the 61 metastatic routes identified, 38 (62.3%) are initiated from the primary tumors, 22 (36.1%) from LNMs, and 1 from liver metastasis (1.6%). In 5 patients, we find 6 LNMs that reseed 2 or more LNMs. We summarize 3 diverse modes of metastasis in CRC and show that skip spreading of tumor cells within the lymphatic network is common. Our study sheds light on the complicated metastatic pattern in CRC and has great clinical implications.

Date: 2020
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DOI: 10.1038/s41467-020-15886-6

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