Lymph Node Metastasis: Scavenger Receptor Mechanisms and Chemotherapy Resistance in Para-Aortic Sanctuary-Like Sites
DOI:
https://doi.org/10.34635/rpc.1211Keywords:
Drug Resistance, Neoplasm, Extracellular Vesicles, Lymph Nodes, Lymphatic Metastasis, Receptors, ScavengerAbstract
Lymph-node metastasis is a major determinant of cancer staging, prognosis and therapeutic decision-making. Rather than functioning as passive filters, tumor-draining lymph nodes are biologically active compartments that undergo vascular, stromal, and immune remodeling before and during metastatic colonization. Tumor-derived soluble mediators, extracellular vesicles, and non-coding RNAs can reach regional lymph nodes through afferent lymphatics and contribute to pre-metastatic niche formation, while stromal and myeloid populations further shape the nodal microenvironment. Within lymph-node sinuses, specialized scavenger and lectin-like receptors expressed by endothelial cells and macrophages constitute a molecular interface that may be involved in tumor-cell adhesion, retention, and immune regulation. Stabilin-1/Clever-1, Stabilin-2, LYVE-1, and MARCO are among the most relevant candidates, although the nature and strength of the supporting evidence differ between receptors. Following metastatic colonization, progressive tumor-stroma interactions may generate vascular dysfunction, increased intranodal pressure, extracellular matrix remodeling, hypoxia, immunosuppression, tumor-cell-intrinsic resistance, and dormancy, all of which may contribute to therapeutic persistence. These mechanisms are particularly relevant to para-aortic lymph-node metastases, which have been discussed as potential sanctuary sites. However, direct human evidence demonstrating systematically reduced therapeutic exposure within para-aortic metastases remains limited. This review integrates pre-metastatic nodal conditioning, scavenger receptor biology, and mechanisms of treatment resistance within a temporal model of lymph node metastatic progression and critically examines whether para-aortic nodal disease may acquire sanctuary-like behavior.
Downloads
References
Reticker-Flynn NE, Engleman EG. Lymph nodes: at the intersection of cancer treatment and progression. Trends Cell Biol. 2023;33:1021-34.
Karaman S, Detmar M. Mechanisms of lymphatic metastasis. J Clin Invest. 2014;124:922-8.
Kakimi K, Kobayashi Y, Nagaoka K. From metastatic gateways to immune reservoirs: reframing tumor-draining lymph nodes in perioperative cancer immunotherapy. Immuno. 2026;6:47. doi: /10.3390/immuno6030047.
Delclaux I, Ventre KS, Jones D, Lund AW. The tumor-draining lymph node as a reservoir for systemic immune surveillance. Trends in Cancer. 2024;10:28-37.
Haist M, Baertsch MA, Reticker-Flynn NE, Lu G, Kempchen TN, Chu P, et al. Lymph node colonization induces tissue remodeling via immunosuppressive fibroblast-myeloid cell niches supporting metastatic tolerance. Cancer Cell. 2026;44:604-623.e609. doi: 10.1016/j.ccell.2026.01.003.
Naxerova K, Reiter JG, Brachtel E, Lennerz JK, van de Wetering M, Rowan A, et al. Origins of lymphatic and distant metastases in human colorectal cancer. Science. 2017;357:55-60. doi: 10.1126/science.aai8515.
Pereira ER, Kedrin D, Seano G, Bouta EM, Chang J, Beech E, et al. Lymph node metastases can invade local blood vessels, exit the node, and colonize distant organs in mice. Science. 2018;359:1403-7. doi: 10.1126/science.aai3622.
Brown M, Assen FP, Leithner A, Abe J, Schachner H, Asfour G, et al. Lymph node blood vessels provide exit routes for metastatic tumor cell dissemination in mice. Science. 2018;359:1408-11. doi: 10.1126/science.aai3662.
Bhandari S, Larsen AK, McCourt P, Smedsrad B, Sørensen KK. The Scavenger Function of Liver Sinusoidal Endothelial Cells in Health and Disease. Front Physiol. 2021;12:757469.
Yu X, Guo C, Fisher PB, Subjeck JR, Wang XY. Scavenger Receptors: Emerging Roles in Cancer Biology and Immunology. Adv Cancer Res. 2015;128:309-64.
Martens JH, Kzhyshkovska J, Falkowski-Hansen M, Schledzewski K, Gratchev A, Mansmann U, et al. Differential expression of a gene signature for scavenger/lectin receptors by endothelial cells and macrophages in human lymph node sinuses, the primary sites of regional metastasis. J Pathol. 2006;208:574-89. doi: 10.1002/path.1921.
Yalcin Y, Kosan B, Yalcin S, Sakinnaz M, Ozerkan K. The effect of para-aortic lymphadenectomy on survival in early stage endometrioid grade 3 and non-endometrioid endometrial cancers. BMC Womens Health. 2025;25:568.
Güner FC, Iltar E, Ates Tkiz M, Doğan S, Doğan NU, Tuncer HA, et al. Factors associated with para-aortic lymph node metastasis in high-risk endometrial cancer. Medicina. 2025;61:2189. doi: 10.3390/medicina61122189.
Ardah MT, Tashkenbaeva U, Abdulqader AF, Kadhim AA, Jamuna KV, Singhal D, et al. Lymphatic extracellular vesicles and non-coding rnas in the melanoma sentinel lymph node pre-metastatic niche: Emerging lessons from aggressive skin cancers. Cancer Treat Res Commun. 2026;48:101298. doi: 10.1016/j.ctarc.2026.101298.
Forder A, Hsing CY, Trejo Vazquez J, Garnis C. Emerging role of extracellular vesicles and cellular communication in metastasis. Cells. 2021;10.
García-Silva S, Benito-Martín A, Nogués L, Hernández-Barranco A, Mazariegos MS, Santos V, et al. Melanoma-derived small extracellular vesicles induce lymphangiogenesis and metastasis through an NGFR-dependent mechanism. Nat Cancer. 2021;2:1387-405. doi: 10.1038/s43018-021-00272-y.
García-Silva S, Peinado H. Mechanisms of lymph node metastasis: An extracellular vesicle perspective. Eur J Cell Biol. 2024;103:151447.
Leary N, Walser S, He Y, Cousin N, Pereira P, Gallo A, et al. Melanoma-derived extracellular vesicles mediate lymphatic remodelling and impair tumour immunity in draining lymph nodes. J Extracellular Vesicles. 2022;11:e12197. doi: 10.1002/jev2.12197.
Ji H, Hu C, Yang X, Liu Y, Ji G, Ge S, et al. Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions. Signal Transduct Target Ther. 2023;8:367. doi: 10.1038/s41392-023-01576-4.
Lambert AW, Pattabiraman DR, Weinberg RA. Emerging Biological Principles of Metastasis. Cell. 2017;168:670-691.
Fontana R, Mestre-Farrera A, Yang J. Update on Epithelial-Mesenchymal Plasticity in Cancer Progression. Annu Rev Pathol. 2024;19:133-56.
Alexandrova A, Lomakina M. How does plasticity of migration help tumor cells to avoid treatment: Cytoskeletal regulators and potential markers. Front Pharmacol. 2022;13:962652.
Yuan J, Zhang R, Geng Z. Cancer-associated fibroblasts in lymph node metastasis: Insights and therapeutic strategies. Chin Med J. 2026;139:502-14.
Cai Q, Cai W, Liu Y, Li M, Xiang SE, Ji H, et al. Advancing lymph node metastasis in head and neck squamous cell carcinoma.
Hirakawa S, Brown LF, Kodama S, Paavonen K, Alitalo K, Detmar M. VEGF-C-induced lymphangiogenesis in sentinel lymph nodes promotes tumor metastasis to distant sites. Blood. 2007;109:1010-7.
Shields JD, Fleury ME, Yong C, Tomei AA, Randolph GJ, Swartz MA. Autologous chemotaxis as a mechanism of tumor cell homing to lymphatics via interstitial flow and autocrine CCR7 signaling. Cancer Cell. 2007;11:526-38.
Montenegro-Navarro N, Garcia-Baez C, Garcia-Caballero M. Molecular and metabolic orchestration of the lymphatic vasculature in physiology and pathology. Nat Commun. 2023;14:8389.
Wang H, Pan J, Barsky L, Jacob JC, Zheng Y, Gao C, et al. Characteristics of pre-metastatic niche: the landscape of molecular and cellular pathways. Mol Biomed. 2021;2:3. doi: 10.1186/s43556-020-00022-z.
Wang L, Li L, Zhu G. Role of Extracellular Vesicles on Cancer Lymphangiogenesis and Lymph Node Metastasis. Front Oncol. 2021;11:2021.
Gillot L, Baudin L, Rouaud L, Kridelka F, Noel A. The pre-metastatic niche in lymph nodes: formation and characteristics. Cell Mol Life Sci. 2021;78:5987-6002.
Lei P-J, Fraser C, Jones D, Ubellacker JM, Padera TP. Lymphatic system regulation of anti-cancer immunity and metastasis. Front Immunol. 2024;15:2024.
Adusumalli R, Banala RR. Cancer-associated fibroblasts at the crossroads of tumor progression and therapy resistance: from heterogeneity to precision reprogramming. J Egyptian National Cancer Inst. 2025;37:81.
Mahjabeen F, Habbani SF, Mohammed SI. Molecular Mechanisms of Lymphatic Metastasis in Breast Cancer: An Updated Review. Cancers. 2025;17:2134.
Qian H, Maghsoudloo M, Kaboli PJ, Babaeizad A, Cui Y, Fu J, et al. Decoding the Promise and Challenges of miRNA-Based Cancer Therapies: An Essential Update on miR-21, miR-34, and miR-155. Int J Med Sci. 2024;21:2781-98. doi: 10.7150/ijms.102123.
Hussein MA, Valinezhad K, Adel E, Munirathinam G. MALAT-1 Is a Key Regulator of Epithelial-Mesenchymal Transition in Cancer: A Potential Therapeutic Target for Metastasis. Cancers. 2024;16:234. doi: 10.3390/cancers16010234.
Kaur J, Salehen N, Norazit A, Rahman AA, Murad NA, Rahman NM, et al. Tumor Suppressive Effects of GAS5 in Cancer Cells. Noncoding RNA. 2022;8:39. doi: 10.3390/ncrna8030039.
Zhang X, Xu X, Song J, Xu Y, Qian H, Jin J, et al. Non-coding RNAs' function in cancer development, diagnosis and therapy. Biomed Pharmacother. 2023;167:115527. doi: 10.1016/j.bioqph.2023.115527.
Xavier CPR, Belisario DC, Rebelo R, Assaraf YG, Giovannetti E, Kopecka J, et al. The role of extracellular vesicles in the transfer of drug resistance competences to cancer cells. Drug Resistance Updates. 2022;62:100833. doi: 10.1016/j.drup.2022.100833.
Sleeman JP. The lymph node pre-metastatic niche. J Mol Med. 2015;93:1173-84.
Hood JL, San RS, Wickline SA. Exosomes released by melanoma cells prepare sentinel lymph nodes for tumor metastasis. Cancer Res. 2011;71:3792-801.
Lin Y, Zheng H, Jia L, Luo Y, Zhang D, An M, et al. Integrin α6-containing extracellular vesicles promote lymphatic remodelling for pre-metastatic niche formation in lymph nodes via interplay with CD151. J Extracellular Vesicles. 2024;13:e12518. doi: 10.1002/jev2.12518.
Han N, Zhou D, Ruan M, Yan M, Zhang C. Cancer cell-derived extracellular vesicles drive pre-metastatic niche formation of lymph node via IFNGR1/JAK1/STAT1-activated-PD-L1 expression on FRCs in head and neck cancer. Oral Oncol. 2023;145:106524.
Su F, Zhang Y, Maimaiti S, Chen S, Shen Y, Feng M, et al. Mechanisms and characteristics of subcapsular sinus macrophages in tumor immunity: a narrative review. Transl Cancer Res. 2023;12:3779-91.
Sun M, Angelillo J, Hugues S. Lymphatic transport in anti-tumor immunity and metastasis. J Exp Med. 2025;222.
Hollmén M, Figueiredo CR, Jalkanen S. New tools to prevent cancer growth and spread: a 'Clever' approach. Br J Cancer. 2020;123:501-9.
Karikoski M, Marttila-Lichihara F, Elima K, Rantakari P, Hollmén M, Kelkka T, et al. Clever-1/stabilin-1 controls cancer growth and metastasis. Clin Cancer Res. 2014;20:6452-64. doi: 10.1158/1078-0432.CCR-14-1236.
Viitala M, Virtakoiu R, Tadayon S, Rannikko J, Jalkanen S, Hollmén M. Immunotherapeutic Blockade of Macrophage Clever-1 Reactivates the CD8(+) T-cell Response against Immunosuppressive Tumors. Clin Cancer Res. 2019;25:3289-303.
Han MW, Lee JC, Park SY, Kim YM, Cho KJ, Kim SW, et al. Homotypic Interaction of Stabilin-2 Plays a Critical Role in Lymph Node Metastasis of Tongue Cancer. Anticancer Res. 2016;36:6611-8. doi: 10.21873/anticancers.11267.
Du Y, Liu H, He Y, Liu Y, Yang C, Zhou M, et al. The interaction between LYVE-1 with hyaluronan on the cell surface may play a role in the diversity of adhesion to cancer cells. PLOS ONE. 2013;8:e63463. doi: 10.1371/journal.pone.0063463.
Elfstrum AK, Rumarhobo AH, Reese LE, Nelson EV, McCluskey BM, Schwertfeger KL. LYVE-1-expressing Macrophages Modulate the Hyaluronan-containing Extracellular Matrix in the Mammary Stroma and Contribute to Mammary Tumor Growth. Cancer Res Commun. 2024;4:1380-97.
Gu C, Wiest M, Zhang W, Halder K, Zurawski S, Zurawski G, et al. Cancer Cells Promote Immune Regulatory Function of Macrophages by Upregulating Scavenger Receptor MARCO Expression. J Immunol. 2023;211:57-70. doi: 10.4049/jimmunol.2300029.
Georgoudaki AM, Prokopec KE, Boura VF, Hellqvist E, Sohn S, Östling J, et al. Reprogramming tumor-associated macrophages by antibody targeting inhibits cancer progression and metastasis. Cell Rep. 2016;15:2000-11. doi: 10.1016/j.celrep.2016.04.084.
Eisinger S, Sarhan D, Boura VF, Ibarlueca-Benitez I, Tyystjärvi S, Oliynyk G, et al. Targeting a scavenger receptor on tumor-associated macrophages activates tumor cell killing by natural killer cells. Proc Natl Acad Sci U S A. 2020;117:32005-16. doi: 10.1073/pnas.2015343117.
Tacconi C, Commerford CD, Dieterich LC, Schwager S, He Y, Ikenberg K, et al. CD169+ lymph node macrophages have protective functions
Virgilio T, Bordini J, Cascione L, Sartori G, Latino I, Molina Romero D, et al. Subcapsular sinus macrophages promote melanoma metastasis to the sentinel lymph nodes via an IL1α-STAT3 axis. Cancer Immunol Res. 2022;10:1525-41. doi: 10.1158/2326-6066.CIR-22-0225.
Jones D, Wang Z, Chen IX, Zhang S, Banerji R, Lei PJ, et al. Solid stress impairs lymphocyte infiltration into lymph-node metastases. Nat Biomed Eng. 2021;5:1426-36. doi: 10.1038/s41551-021-00766-1.
Meijer EF, Blatter C, Chen IX, Bouta E, Jones D, Pereira ER, et al. Lymph node effective vascular permeability and chemotherapy uptake. Microcirculation. 2017;24:10.1111/micc.12381. doi: 10.1111/micc.12381.
Kato S, Takeda K, Sukhbaatar A, Sakamoto M, Mori S, Shiga K, et al. Intranodal pressure of a metastatic lymph node reflects the response to lymphatic drug delivery system. Cancer Sci. 2020;111:4232-41. doi: 10.1111/cas.14640.
Jacobetz MA, Chan DS, Neesse A, Bapiro TE, Cook N, Frese KK, et al. Hyaluronan impairs vascular function and drug delivery in a mouse model of pancreatic cancer. Gut. 2013;62:112-20. doi: 10.1136/gutjnl-2012-302529.
Chauhan VP, Martin JD, Liu H, Lacorre DA, Jain SR, Kozin SV, et al. Angiotensin inhibition enhances drug delivery and potentiates chemotherapy by decompressing tumour blood vessels. Nat Commun. 2013;4:2516. doi: 10.1038/ncomms3516.
Star-Lack JM, Adalsteinsson E, Adam MF, Terris DJ, Pinto HA, Brown JM, et al. In vivo 1H MR spectroscopy of human head and neck lymph node metastasis and comparison with oxygen tension measurements. AJNR Am J Neuroradiol. 2000;21:183-93.
Branco H, Xavier CPR, Riganti C, Vasconcelos MH. Hypoxia as a critical player in extracellular vesicles-mediated intercellular communication between tumor cells and their surrounding microenvironment. Biochim Biophys Acta Rev Cancer. 2025;1880:189244.
Cheng X, Xu M, Wei J, Cao C. Cancer drug response and resistance: molecular mechanisms and combating strategies. Signal Transduct Target Ther. 2026;11:307. doi: 10.1038/s41392-026-02924-w.
Qian J, Liao G, Chen M, Peng RW, Yan X, Du J, et al. Advancing cancer therapy: new frontiers in targeting DNA damage response. Front Pharmacol. 2024;15:1474337. doi: 10.3389/fphar.2024.1474337.
Sosa MS, Bragado P, Aguirre-Ghiso JA. Mechanisms of disseminated cancer cell dormancy: an awakening field. Nat Rev Cancer. 2014;14:611-22.
Min HY, Lee HY. Cellular Dormancy in Cancer: Mechanisms and Potential Targeting Strategies. Cancer Res Treat. 2023;55:720-36.
Aguirre-Ghiso JA, Estrada Y, Liu D, Ossowski L. ERK(MAPK) activity as a determinant of tumor growth and dormancy; regulation by p38(SAPK). Cancer Res. 2003;63:1684-95.
Lamorte S, Quevedo R, Jin R, Neufeld L, Liu ZQ, Ciudad MT, et al. Lymph node macrophages drive immune tolerance and resistance to cancer therapy by induction of the immune-regulatory cytokine IL-33. Cancer Cell. 2025;43:955-969.e910. doi: 10.1016/j.ccell.2025.02.017.
Connolly KA, Kuchroo M, Venkat A, Khatun A, Wang J, William I, et al. A reservoir of stem-like CD8(+) T cells in the tumor-draining lymph node preserves the ongoing antitumor immune response. Sci Immunol. 2021;6:eabg7836. doi: 10.1126/sciimmunol.abg7836.
Rahim MK, Okholm TLH, Jones KB, McCarthy EE, Liu CC, Yee JL, et al. Dynamic CD8(+) T cell responses to cancer immunotherapy in human regional lymph nodes are disrupted in metastatic lymph nodes. Cell. 2023;186:1127-1143.e1118. doi: 10.1016/j.cell.2023.02.021.
Pérez-Velázquez J, Gevertz JL, Karolak A, Rejniak KA. Microenvironmental Niches and Sanctuaries: A Route to Acquired Resistance. Adv Exp Med Biol. 2016;936:149-64.
Brunner M, Kitzke L, Mittelstadt A, Merkel S, Weber GF, Grutzmann R, et al. The prognostic role of para-aortic lymph node metastasis in patients with resected pancreatic adenocarcinoma. Cancers. 2025;17:3418. doi: 10.3390/cancers17213418.
Bartelink IH, Jones EF, Shahidi-Latham SK, Lee PR, Zheng Y, Vicini P, et al. Tumor Drug Penetration Measurements Could Be the Neglected Piece of the Personalized Cancer Treatment Puzzle. Clin Pharmacol Ther. 2019;106:148-63. doi: 10.1002/cpt.1211.
Wang RC, Wang JQ, Zhou XY, Zhong CL, Chen JX, Chen JS. Survival benefits of para-aortic lymphadenectomy in colorectal cancer with clinically suspected para-aortic lymph node metastasis: a meta-analysis and systematic review. World J Surg Oncol. 2023;21:28.
Glynne-Jones R, Harrison M. Colorectal cancer para-aortic lymph node metastases: surgery should not be considered. Br J Surg. 2024;111.
Peacock O. Colorectal cancer para-aortic lymph node metastases-surgery should be considered. Br J Surg. 2024;111.
Tsuburaya A, Mizusawa J, Tanaka Y, Fukushima N, Nashimoto A, Sasako M. Neoadjuvant chemotherapy with S-1 and cisplatin followed by D2 gastrectomy with para-aortic lymph node dissection for gastric cancer with extensive lymph node metastasis. Br J Surg. 2014;101:653-60.
Wada T, Yokoyama M, Ito S, Hashimoto T, Kawabata K, Ehara K, et al. Therapeutic value of para-aortic lymph node dissection in gastric cancer with extensive lymph node metastasis: integrated analysis of three phase II trials (JCQG2212A). Gastric Cancer. 2026;29:865-73. doi: 10.1007/s10120-026-01752-9.
Poitevin Chacon A, Chavez-Nogueda J, Ramos-Prudencio R, Villavicencio-Queijeiro MA, Lozano-Ruiz F. The role of para-aortic nodal irradiation in cervical cancer. Rep Pract Oncol Radiother. 2018;23:540-6.
Cibula D, Raspollini MR, Planchamp F, Centeno C, Chargari C, Felix A, et al. ESGO/ESTRO/ESP Guidelines for the management of patients with cervical cancer - Update 2023. Int J Gynecol Cancer. 2023;33:649-66. doi: 10.1136/ijgc-2023-004429.
Quail DF, Joyce JA. Cancer ecosystems: A dynamic interplay across scales. Cell. 2026;189:2441-63.
Kilmister EJ, Koh SP, Weth FR, Gray C, Tan ST. Cancer Metastasis and Treatment Resistance: Mechanistic Insights and Therapeutic Targeting of Cancer Stem Cells and the Tumor Microenvironment. Biomedicines. 2022;10.
Bae SU, Hur H, Min BS, Baik SH, Lee KY, Kim NK. Which Patients with Isolated Para-aortic Lymph Node Metastasis Will Truly Benefit from Extended Lymph Node Dissection for Colon Cancer? Cancer Res Treat. 2018;50:712-9.
Pelc Z, Skórzewska M, Rawicz-Pruszynski K, Polkowski WP. Lymph Node Involvement in Advanced Gastric Cancer in the Era of Multimodal Treatment-Oncological and Surgical Perspective. Cancers. 2021;13.
Wu Y, Zhu B, Han J, Xu H, Gong Z, Yang Y, et al. A comparative dosimetric study of cervical cancer patients with para-aortic lymph node metastasis treated with volumetric modulated arc therapy vs. 9-field intensity-modulated radiation therapy. Ann Transl Med. 2019;7:675. doi: 10.21037/atm.2019.10.53.
Rannikko JH, Verlingue L, de Miguel M, Pasanen A, Robbrecht D, Skytta T, et al. Bexmariimab-induced macrophage activation leads to treatment benefit in solid tumors: The phase I/II first-in-human MATINS trial. Cell Rep Med. 2023;4:101307. doi: 10.1016/j.xcrm.2023.101307.
Kontro M, Stein AS, Pyorala M, Rimpilainen J, Siitonen T, Ylitalo A, et al. Bexmariimab plus azacitidine for high-risk myelodysplastic syndrome and relapsed or refractory acute myeloid leukaemia: results from the dose-escalation part of a multicentre, single-arm, phase 1/2 trial. Lancet Haematol. 2025;12:e516-e528. doi: 10.1016/S2352-3026(25)00103-6.
Rannikko JH, Hollmén M. Clinical landscape of macrophage-reprogramming cancer immunotherapies. Br J Cancer. 2024;131:627-40.
DeFranciscis V, Amabile G, Kortylewski M. Clinical applications of oligonucleotides for cancer therapy. Mol Ther. 2025;33:2705-18.
Manspeaker MP, Thomas SN. Lymphatic immunomodulation using engineered drug delivery systems for cancer immunotherapy. Adv Drug Deliv Rev. 2020;160:19-35.
Tada A, Horie S, Mori S, Kodama T. Therapeutic effect of cisplatin given with a lymphatic drug delivery system on false-negative metastatic lymph nodes. Cancer Sci. 2017;108:2115-21.
Wei J, Li D, Long H, Han M. Immune microenvironment of tumor-draining lymph nodes: insights for immunotherapy. Front Immunol. 2025;16:2025.
Telarovic I, Yong CS, Kurz L, Vetrugno I, Reichl S, Fernandez AS, et al. Delayed tumor-draining lymph node irradiation preserves the efficacy of combined radiotherapy and immune checkpoint blockade in models of metastatic disease. Nat Commun. 2024;15:5500. doi: 10.1038/s41467-024-49873-y.
Guo W, Zhou B, Dou L, Guo L, Li Y, Qin J, et al. Single-cell RNA sequencing and spatial transcriptomics of esophageal squamous cell carcinoma with lymph node metastases. Exp Mol Med. 2025;57:59-71. doi: 10.1038/s12276-024-01369-x.
Rayamajhi S, Sipes J, Tetlow AL, Saha S, Bansal A, Godwin AK. Extracellular Vesicles as Liquid Biopsy Biomarkers across the Cancer Journey: From Early Detection to Recurrence. Clin Chem. 2024;70:206-19.
Chang M, Papazyan T, Pons-Tostivint E, Fradin D. Unlocking the power of non-coding RNAs: toward real-time cancer monitoring in precision oncology. Molecular Cancer. 2026;25:34.
Abbosh C, Frankell AM, Harrison T, Kisistok J, Garnett A, Johnson L, et al. Tracking early lung cancer metastatic dissemination in TRACERx using ctDNA. Nature. 2023;616:553-62. doi: 10.1038/s41586-023-05776-4.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Portuguese Journal of Surgery
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Para permitir ao editor a disseminação do trabalho do(s) autor(es) na sua máxima extensão, o(s) autor(es) deverá(ão) assinar uma Declaração de Cedência dos Direitos de Propriedade (Copyright). O acordo de transferência, (Transfer Agreement), transfere a propriedade do artigo do(s) autor(es) para a Sociedade Portuguesa de Cirurgia.
Se o artigo contiver extractos (incluindo ilustrações) de, ou for baseado no todo ou em parte em outros trabalhos com copyright (incluindo, para evitar dúvidas, material de fontes online ou de intranet), o(s) autor(es) tem(êm) de obter, dos proprietários dos respectivos copyrights, autorização escrita para reprodução desses extractos do(s) artigo(s) em todos os territórios e edições e em todos os meios de expressão e línguas. Todas os formulários de autorização devem ser fornecidos aos editores quando da entrega do artigo.
