Changes in the metabolism of axillary lymph node cells as a predictor of regional metastasis in breast cancer.

BACKGROUND: Recent studies have shown that the delayed luminescence of erythrosine (DLE) indicators differs between tumor and nontumor breast tissue in patients with breast cancer (BC). AIM: To study the features of metabolism of axillary lymph node (ALN) cells and their relationship with regional metastasis in BC patients. METHODS: This prospective, single-center, observational cohort study included 69 patients with newly diagnosed BC. DLE indicators were measured for 152 ALNs. DLE decay kinetics were recorded using flash photolysis. A control circuit interfaced the analog measuring devices and digital data processing systems. Eighty-eight and 74 ALN samples were stained with antibodies against vascular cell adhesion molecule-1 (VCAM-1) and C-X-C motif chemokine receptor 4 (CXCR4), respectively. Statistical calculations were performed using Statistica version 12.0 software. RESULTS: Singlet oxygen-sensitized delayed fluorescence (SOSDF) indicators were significantly lower, whereas phosphorescence and thermally activated delayed fluorescence indicators were significantly higher in ALNs with metastases than in those without metastases (P < 0.0001). Pronounced VCAM-1 expression in ALNs was significantly more common in patients with tumor grade 3 and human epidermal growth factor receptor 2 (HER2) overexpression and in patients with HER2-positive BC. Pronounced CXCR4 expression in lymph node (LN) follicles was detected significantly more often in patients with metastases in ALNs and with lymphovascular invasion. The intensity of delayed phosphorescence positively correlated with both VCAM-1 and CXCR4 expression in the LN follicles, and VCAM-1 expression in the LN follicles was negatively correlated with SOSDF and positively correlated with the duration of delayed phosphorescence. CONCLUSION: These results indicate that metastatic LNs exhibit greater oxygen consumption by tumor cells and that changes in tumor cell metabolism are associated with increased CXCR4 and VCAM-1 expression in ALNs.