Disturbed meningeal lymphatic function associated with malignancy and progression in patients with intracranial malignant tumors

Med. 2023 Dec 8;4(12):898-912.e4. doi: 10.1016/j.medj.2023.10.001. Epub 2023 Nov 8.

Abstract

Background: Meningeal lymphatic vessels (mLVs) have proven to bear a relationship with tumor immunity and therapeutic efficacy of intracranial malignant tumors in pre-clinical animal studies. We aimed to explore the association between mLV function and intracranial malignant tumors in clinical participants.

Methods: The participants were allocated to a control group or a group of patients with intracranial tumors. Dynamic enhanced magnetic resonance was used to evaluate the wash-in and wash-out functions of mLVs around the superior sagittal sinus and the sigmoid sinus.

Findings: A total of 246 individuals were recruited for our study. The area under curve and wash-in rate of mLVs in the intracranial tumor group were higher than in the control group (2,749 vs. 2,110, p < 0.001 and 3.72 vs. 2.87, p < 0.001, respectively). The wash-out ratio of mLVs was lower in the intracranial tumor group than in the control group (0.65 vs. 0.73, p < 0.001). Decreased wash-out of mLVs was associated with tumor progression (β = -0.118; p < 0.001). High-grade glioma and isocitrate dehydrogenase wild type were associated with a lower mLV wash-out function (β = -0.057, p = 0.044 and β = -0.069, p = 0.047, respectively).

Conclusions: Intracranial malignant tumors were associated with elevated wash-in function and decreased wash-out function of mLVs. High-grade glioma and isocitrate dehydrogenase wild type were associated with low mLV wash-out function, and long-term decreased mLV wash-out function was a risk factor for tumor progression.

Funding: There was no funding.

Keywords: Translation to patients; deep cervical lymph nodes; intracranial malignant tumors; magnetic resonance imaging; meningeal lymphatic vessels.

MeSH terms

  • Animals
  • Brain Neoplasms* / diagnostic imaging
  • Glioma*
  • Humans
  • Isocitrate Dehydrogenase
  • Lymphatic Vessels*
  • Magnetic Resonance Imaging

Substances

  • Isocitrate Dehydrogenase