肿瘤引流淋巴结（TDLN）在抑制恶性肿瘤中发挥着关键作用，然而，结直肠癌（CRC）中大TDLN（L-TDLN）和小TDLN（S-TDLN）之间的免疫学特征和预后差异我们利用中国国家癌症中心 (CNCC) 数据库的数据进行了一项研究，识别了 837 名患有非转移性 TDLN 的 CRC 患者，并将他们分为 L-TDLN 和 S-TDLN 组。比较两组的长期生存结局和辅助治疗效果。此外，我们通过 RNA 测序和免疫组织化学 (IHC) 染色评估了 L-TDLN 和 S-TDLN 组患者之间免疫激活状态和免疫细胞亚群的差异。与患有 L-TDLN 的患者相比，L-TDLN 患者表现出更好的长期结果。 S-TDLN。在 L-TDLN 患者中，接受辅助化疗和未接受辅助化疗的患者的长期结局没有显着差异。 RNA 测序数据揭示了 L-TDLN 中探索的大量免疫激活途径。此外，IHC 分析表明，与 S-TDLN 患者相比，L-TDLN 和相应的 CRC 病变中 CD3 和 CD8  T 细胞的数量更高。扩大的 TDLN 表现出激活的抗肿瘤免疫特征，可作为有利的指标。非转移性 CRC 的生存。© 2023。作者，获得 Springer Nature Limited 的独家许可。

The tumour-draining lymph node (TDLN) plays a pivotal role in the suppression of malignant tumour, however, the immunological profile and prognostic differences between large TDLN (L-TDLN) and small TDLN (S-TDLN) in colorectal cancer (CRC) remain unclear.We conducted a study using data from the Chinese National Cancer Center (CNCC) database, identifying 837 CRC patients with non-metastatic TDLN, and categorised them into L-TDLN and S-TDLN groups. The long-term survival outcomes and adjuvant therapy efficacy were compared between the two groups. Furthermore, we evaluated the differences in immune activation status and immune cell subsets between patients in L-TDLN and S-TDLN groups by RNA sequencing and immunohistochemical (IHC) staining.Patients with L-TDLN demonstrated better long-term outcomes compared to those with S-TDLN. Among patients with L-TDLN, there was no significant difference in long-term outcomes between those who received adjuvant chemotherapy and those who did not. The RNA sequencing data revealed a wealth of immune-activating pathways explored in L-TDLN. Furthermore, IHC analysis demonstrated higher numbers of CD3+ and CD8 + T cells in L-TDLN and the corresponding CRC lesions, as compared to patients with S-TDLN.Enlarged TDLN exhibited an activated anti-tumour immune profile and may serve as an indicator for favourable survival in non-metastatic CRC.© 2023. The Author(s), under exclusive licence to Springer Nature Limited.