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In one cohort, TDLNs exhibited marked FOXP3 + Treg accumulation that was more pronounced in adenocarcinoma than in squamous cell carcinoma, accompanied by reductions in natural killer cells, consistent with a more strongly Treg-skewed immunosuppressive program in adenocarcinoma ( + proportions and a higher FOXP3/CD8 ratio compared with adenocarcinoma nodes without metastasis, whereas analogous differences were not observed in squamous cell carcinoma nodes ( Other studies have described the role of additional cell populations in the TDLN in patients with NSCLC and are listed in Table 1 ( 5.3 Genomic alteration relevance in the nodal microenvironment Lung cancers exhibit a high degree of chromosomal instability and evolve into clonal and subclonal populations with different genomic features in regions of the same tumor ( EGFR mutant tumors raises the prospect that tumor genotype could more broadly influence TDLN conditioning ( Further characterization of intra- and inter-tumoral heterogeneity via the TDLNs may eventually help with biomarker development and selection of combination therapies
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