tbuckley/cabot-search huggingface dataset:
Cell Survival Failure in Effector T Cells From Patients With Systemic Lupus Erythematosus Following Insufficient Up‐Regulation of Cold‐Shock Y‐Box Binding Protein 1
Authors: Stefan Meltendorf, Hang Fu, Mandy Pierau, Jonathan A. Lindquist, Stephanie Finzel, Peter R. Mertens, Steffi Gieseler‐Halbach, Andreas Ambach, Ulrich Thomas, Holger Lingel, Reinhard E. Voll, Monika C. Brunner‐Weinzierl
Journal: Arthritis & Rheumatology (2020)

Objective The importance of cold‐shock Y‐box binding protein 1 (YB‐1) for cell homeostasis is well‐documented based on prior observations of its association with certain cancer entities. This study was undertaken to explore the role of YB‐1 in T cell homeostasis and survival and the potential contribution of YB‐1 to the pathogenesis of systemic lupus erythematosus (SLE). Methods In the peripheral blood from 25 SLE patients and 25 healthy donors, the expression of YB‐1 and frequency of T cell apoptosis was analyzed by quantitative polymerase chain reaction (qPCR) and fluorescence‐activated cell sorting of CD4+ T cells ex vivo and also analyzed in T cells in vitro after 6 days of stimulation with anti‐CD3–coupled or anti‐CD3/anti‐CD28–coupled microspheres. YB‐1 was overexpressed using lentiviral transduction with wild‐type green fluorescent protein (wtGFP) YB‐1, and knockdown of YB‐1 was achieved using specific short hairpin RNA (shRNA) (3‐fold reduction; P &lt; 0.0001). Results YB‐1 expression was significantly lower in apoptosis‐prone T cells and in activated T cells from SLE patients compared to YB‐1 expression in nonapoptotic T cells and activated T cells from healthy donors ( P = 0.001). Knockdown of YB‐1 in T cells consequently led to expression of proapoptotic molecules and caspase 3 activation (1.6‐fold), and subsequently, to apoptosis. Furthermore, YB‐1 promoted survival pathways involving enhanced protein expression of the kinase Akt (2‐fold) and Bcl‐2 (3‐fold), even when Fas/CD95 was triggered. YB‐1–mediated T cell survival was reversed by Akt and phosphatidylinositol 3‐kinase (PI3K) inactivation. In SLE patients, rescue of YB‐1 expression strongly promoted survival of T cells and even prevented cell death in T cells that were extremely apoptosis‐prone. Conclusion Our data show that failure of YB‐1 up‐regulation in T cells from SLE patients led to enhanced apoptosis. These findings imply that YB‐1 plays a crucial role in the disturbed homeostasis of activated T cells leading to hematopoietic alterations in SLE. These insights may help facilitate the development of new treatment strategies for SLE.
Application of 360 degree evaluation in competency assessment of community general practice trainers
Authors: Tianhao Wang, Zhigang Pan, Jie Gu, Yuan Zhang
Journal: BMJ (2014)

Objective
To apply 360 degree evaluation in competence assessment of community general practice trainers.


Methods
The 360 degree evaluation questionnaire was designed by authors and the evaluation was applied to assess the personal comprehensive quality, competence in general practice and teaching of 16 general practice trainers in Fenglin Community Health Service Center of Shanghai Xuhui District.


Results
The scores of personal comprehensive quality, competency in general practice and teaching were 7.73±0.73, 6.91±0.91 and 6.44±1.38, respectively. The total scores from different evaluators were 6.93±0.12 for peers, 6.68±0.74 for hospital executives, 8.17±0.12 for nurses and 6.43±0.89 from self evaluation(F=27.91, P=0.000).


Conclusion
The variance between different evaluators in 360 degree evaluation can avoid bias of single one. The results of 360 degree evaluation show that the teaching ability of community general practice trainer is relatively low, suggesting the training of teaching ability should be strengthened for these trainers.


Key words: 
General practitioner; Teacher training; 360 degree evaluation
Prospective analysis of antinuclear antibodies prevalence in a pan-tumor sample.
Authors: Silvia Roa, Ana López-Alfonso, Inmaculada Toboso del Amo, Sandra Falagan, Francisco Zambrana, Miriam Lopez-Gomez, Ana M. Jimenez-Gordo, Cesar Gomez Raposo, Maria Merino, Cristina Aguayo, Enrique Casado, Juan Moreno-Rubio, Maria Sereno
Journal: Journal of Clinical Oncology (2020)

e15012 Background: Antinuclear antibodies (ANAs) constitute a spectrum of autoantibodies targeted to nuclear and cytoplasmic components of the cells considered serological markers for different autoimmune disease. However, ANAs are also presented in different types of cancers. Here, we present an exploratory analysis of ANAs patterns detected in patients with a recent cancer diagnosis. Methods: We carried out a prospective analysis of patients recently diagnosed of cancer in two centers. All were tested for ANAs from January to December 2019. Clinical-pathological features were collected from clinical reports. Results: 190 patients were included with different tumors: Lung(56.3%); colon/rectum(16.3%); head-neck(10.5%); pancreas(3.6%); stomach(3.1%); sarcoma(3.1%); urothelial(2.6%) and others( 3.6%). Most of the patients (pts) had stage IV (65.7%) and III (26.8%). Several histologies were included: adenocarcinoma(55.7%); squamous (32.6%) and others (transitional, clear cells, small cell and mesotelial/sarcoma). Chemotherapy was the main treatment (73.6%pts) followed by immunotherapy (11.5%pts), targeted therapy (6.8%pts) and chemo-inmunotherapy (3.1%pts). Among all pts included, only 13 had autoimmune disease: polymyalgia rheumatica (1pt); psoriasis (4pts), bronchial hyperreactivity (2pts) and hypotiroidism (6pts). In this cohort, we found that 60/190, 31.5%pts, showed positive ANAs (+) titers by immunofluorescence analysis. Different patterns were described according to First International Consensus on Standardized Nomenclature of ANAs. The predominant was a speckled pattern presented in 26% pts; secondly, a nucleolar pattern in 16.6% pts and CENP-F AC14 was presented in 8.3%pts. More minoritary patterns were also described. Patients with advanced lung cancer included 56.6% of ANAs (+) cases followed by colorectal cancer (11.6%). Adenocarcinoma (73,3 % pts) and squamous carcinoma (16,6% pts) were the most common histologies among ANAs (+) cases but none of the small cell carcinoma were ANA(+). The majority of ANAs (+) patients were on chemotherapy (73.3 % pts) followed by immunotherapy (16.6% pts). On the other hand, 4/13 of patients with autoimmune diseases presented ANAs(+) titers (CENT-F, scl70 and AC3 patterns). The only patient who developed a severe inmune-related toxicity was ANA negative. Conclusions: In this study, we describe the prevalence of ANAs and their patterns in a cohort of cancer patients. A complementary description of relevant clinical-pathological features in ANAs(+) subgroup is also reported.
中国消化不良的诊治指南(2007,大连)
Authors: 中华医学会消化病学分会胃肠动力学组
Journal: BMJ (2008)

一、定义 消化不良(dyspepsia)是指一组表现为上腹部疼痛或烧灼感、餐后上腹饱胀和早饱感的症候群,可伴食欲不振、嗳气,恶心或呕吐等[1-3].消化不良症状的产生与消化系统器官疾病有关,从病因上可分为器质性消化不良(organicdyspepsia,OD)和功能性消化不良(functional dyspepsia,FD).其中,FD患者的症状源于上腹部,血生化及内镜等检查无异常发现,临床表现难以用器质性疾病解释[3]。
Treatment of 5413 hypertensive patients: a cross-sectional study
Authors: 刘岚, 邵隽一
Journal: BMJ (2013)

背景
在丹麦，多数高血压患者是在基层医疗中被管理的，但有研究显示，其中仅有21%～43%患者的血压得到控制。在为高血压患者制定个体优化治疗方案时有些重要因素需要考虑，如其所用的抗高血压药物、危险因素和心血管疾病。


目的
根据丹麦高血压指南，对一个全科医疗照料下的群体，评价血压控制情况的依据与伴有的危险因素、心血管疾病以及是否有糖尿病相关，普通患者正常血压为<140/90 mm Hg(1 mm Hg＝0.133 kPa)，糖尿病患者正常血压为<130/80 mm Hg。


方法
在丹麦进行的一项横断面研究，有184个全科诊所和5413例高血压患者参与。全科医师填表记录每位患者的危险因素、心血管疾病以及抗高血压药物治疗情况，患者填写有关危险因素的问卷。以丹麦高血压指南的血压理想值和抗高血压药物使用状况作为评价指标。


结果
患者平均年龄65.9岁(95%CI：65.6～66.1)。研究人群中有29.1%达到理想的血压控制水平(95%CI：27.9～30.3)；在842例伴或不伴有心血管疾病的糖尿病患者中，仅有10.9%(95%CI：8.8～10.3)的患者达到理想的血压标准；合并心血管疾病的患者中有38.7%(95%CI：35.5～41.9)血压控制达到理想水平。大多数患者接受1种[占32.5%, 95%CI：32.5 (31.3～33.8)]或2种抗高血压药物治疗(占39.0%, 95%CI：38.2～40.8)。在合并有糖尿病的高血压患者中，有17.7%的患者未用血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂治疗。


结论
在全科医疗中，高血压患者达到理想血压控制水平的比例太低，大多数高血压患者仅用1种或2种抗高血压药物治疗。
The Xenobiotic Transporter Mdr1 Enforces T Cell Homeostasis in the Presence of Intestinal Bile Acids
Authors: Wei Cao, Hisako Kayama, Mei Lan Chen, Amber Delmas, Amy Sun, Sang Yong Kim, Erumbi S. Rangarajan, Kelly McKevitt, Amanda P. Beck, Cody B. Jackson, Gogce Crynen, Angelos Oikonomopoulos, Precious N. Lacey, Gustavo J. Martinez, Tina Izard, Robin G. Lorenz, Alex Rodriguez-Palacios, Fabio Cominelli, Maria T. Abreu, Daniel W. Hommes, Sergei B. Koralov, Kiyoshi Takeda, Mark S. Sundrud
Journal: Immunity (2020)
Effect of community management of type 2 diabetes patients with signing on family doctor service in Shanghai
Authors: Wen Long, Rong Shi, Lili Jia, Shengbing Zhang, Daoping Song, Yun Peng, Ming Cui, Hui Zhang, Qinkang Jiang, Jingfen Zhu, Yi Feng, Jieqiong Lou, Hui Yang, Fei Qin
Journal: BMJ (2018)

Objective
To assess the effect of community management of type 2 diabetes mellitus (T2DM) patients with signing on family doctor service in Shanghai.


Methods
Six community health service centers in two Shanghai districts were selected by cluster random sampling method from April 2014 to March 2017. T2DM patients, who visited the community health service centers more than three times in the last one year, were enrolled in the study. The questionnaire survey was conducted and lab tests were documented.


Results
A total of 5 078 T2DM patients were enrolled in this study, among whom 2 033 had signed contract service with family doctors (signing group) with a signing rate of 40.8%. Compared to non-signing group, the patients in the signing group were better followed the recommendations of blood glucose control [64.6% (1 320/2 053) vs. 35.7% (1 061/2 978)], diet [64.6% (1 320/2 053) vs. 35.7% (1 061/2 978)] and physical activity [63.4%(1 295/2 053)vs. 34.8% (1 033/2 978)](χ2=356.507, 400.649 and 393.996, P<0.01). The medication compliance rate and regular exercise rate in signing group were higher than those in non-signing group [80.2% (1 615/2 053) vs. 77.6% (2 272/2 978), χ2=3.894, P< 0.05; 81.8% (1 679/2 053) vs. 74.5% (2 215/2 978), χ2=38.084, P< 0.05]. The control rates of GLU, 2 h PPG, HbA1c, and blood pressure in signing group were higher than those in non-signing group [40.0% (823/2 053) vs. 35.9% (1 069/2 978), 47.3% (971/2 053) vs.45.4% (1 352/2 978), 35.2%(722/2 053) vs. 32.5%(968/2 978), χ2=18.495, 5.218, 5.006, all P<0.05].


Conclusion
The community management with signing on family doctor service enhances the improvement of health related behaviors in patients with type 2 diabetes; but currently the rate of contract signing is still low.


Key words: 
Diabetes mellitus; Treatment outcome; Physicians, family; Contract
秋、冬季型恙虫病87例临床分析
Authors: 武金喜
Journal: BMJ (2005)

为探讨秋、冬季型恙虫病的临床特征,将87例恙虫病患者按发病季节不同分为秋季型(9～11月份发病)和冬季型(12～2月份发病),分析其流行病学特点和临床表现、辅助检查、治疗及预后的资料.结果秋季型恙虫病发病较集中,临床表现典型,中毒症状重,易出现多脏器损伤,诊断较易,误诊率低,但治愈时间较长,平均住院6.8 d;冬季型恙虫病多呈散发趋势,临床表现多不典型,中毒症状轻,多脏器损伤者少,误诊率较高,治愈时间较短,平均住院4.3 d。
Single-arm, open-label phase 2 trial of pembrolizumab in patients with leptomeningeal carcinomatosis
Authors: Priscilla K. Brastianos, Eudocia Quant Lee, Justine V. Cohen, Sara M. Tolaney, Nancy U. Lin, Nancy Wang, Ugonma Chukwueke, Michael D. White, Naema Nayyar, Albert Kim, Christopher Alvarez-Breckenridge, Ian Krop, Maura Keeley Mahar, Mia S. Bertalan, Brian Shaw, Joana L. Mora, Nathaniel Goss, Megha Subramanian, Lakshmi Nayak, Jorg Dietrich, Deborah A. Forst, Brian V. Nahed, Tracy T. Batchelor, Helen A. Shih, Elizabeth R. Gerstner, Beverly Moy, Donald Lawrence, Anita Giobbie-Hurder, Scott L. Carter, Kevin Oh, Daniel P. Cahill, Ryan J. Sullivan
Journal: Nature Medicine (2020)
A real-world single-center retrospective study on efficacy and safety of pegylated interferon alpha-2a in patients with myeloproliferative neoplasm.
Authors: Muhit Ozcan, Derya Koyun, Guldane Cengiz Seval, Atilla Uslu, Ekin Kırcalı, Cemaleddin Ozturk, Sinem Civriz Bozdag, Selami Kocak Toprak, Pervin Topcuoglu, Onder Arslan, Osman Ilhan, Meral Beksac
Journal: Journal of Clinical Oncology (2020)

e19536 Background: Pegylated forms of interferon (PEG-IFN) have a better pharmacologic profile than short-acting interferons, resulting in a more convenient less-frequent schedule of injections, less immunogenicity and possibly less toxicity. Several clinical studies of PEG-IFN-α-2a have reported promising results in patients with essential thrombocythemia (ET) and polycythemia vera (PV). Herein, we present the outcomes of MPN patients treated with PEG-IFN-α-2a seen outside of a clinical trial setting at a single center. Methods: Thirty-five MPN Patients treated with PEG-IFN-α-2a between January 2014 and October 2019 were included this retrospective analyses. Therapeutic responses for ET and PV were calculated by the revised ELN/IWG-MRT criteria. Responses in myelofibrosis (MF) were calculated by both EUMNET and ELN/IWG-MRT criteria. Best responses over all cycles of treatment were assessed. Molecular data was limited to JAK V617F. Results: Twenty patients with ET, 13 with PV and two with MF were enrolled in this study. The median age at diagnosis was 47 years (range; 21-83 years). JAK2 V617F mutation was detected in 16 patients (45.7%). Overall, the majority of patients (62.9%) had received at least one prior cytoreductive therapy for underlying disease. Median starting dose of PEG-IFN-α-2a was 90 mcg/week via self injection (range: 45-135 mcg/w). Treatment duration was pursued for a median duration of 21.4 months (range: 1.2-109.8). In the PV/ET group 33 patients were evaluated and overall best response rate was 87.8% (CR in 15 pts and PR in 14 pts). In the MF group (n = 2); a PR was seen in one patient and CR in one patient. No vascular events occurred within the cohort while on therapy. Of the eight patients receiving at least phelebotomy per month, all patients became phelobotomy independent with therapy. Of the 20 ET patients, 12 patients (60%) had platelet normalization (&lt; 450 x 10 9 /L). Among all patients, fatigue (31.4%), muscle pain (20%) and depression (8.6%) were the most common adverse events (AEs). Any grade of hematological AEs was not seen with PEG-IFN-α-2a. Eleven patients discontinued therapy secondary to: treatment associated severe AEs in 8 patients, lack of response in two patients and pregnancy in one patient. No death was reported during the analyses period. Conclusions: Our results suggest that PEG-IFN-α-2a remains a viable treatment option especially for younger patients who want to avoid prolonged cytotoxic therapy.
A survey on the prevalence of depression symptoms and risk factors among postgraduates in a university in Shanghai
Authors: Nana Li
Journal: BMJ (2018)

Objective
To investigate thedepression status and the related risk factors of depression among postgraduates in a university in Shanghai.


Methods
A cross-sectional study was conducted in 249 postgraduates from a university in Shanghai to investigate the general information, depression status and awareness of graduate students through the Health Questionnaire Depression Scale (PHQ-9) and self-made questionnaires.


Results
In this survey, the overall prevalence of depression symptoms among postgraduates was 49.8% (124/249); 36.1% (90/249) had mild depressive symptoms, 9.2% (23/249) had moderate symptoms, 2.8% (7/249) had moderate-to-severe depressive symptoms, and 1.6%(4/249) had severe depressive symptoms.83.9% (208/249) of postgraduates believed that the occurrence and development of depression is related to academic pressure; 54.2% (135/249) of them believed that psychosomatic treatment can reduce the occurrence and development of depressive symptoms; when they are aware of depressive symptoms, 87.6% (218/249) of them chose to go to the psychological counseling center.Medical students (OR=0.441, 95%CI: 0.232-0.837), personality (OR=0.562, 95%CI: 0.326-0.969) and physical fitness (OR=2.813, 95%CI: 1.524-5.190)were associated with depressive symptoms (P<0.05).


Conclusion
Non-medical students, feeling introverted and poor physical quality are the risk factors of depressive symptoms in postgraduates and need to be alert to mental health of the students with these factors.


Key words: 
Depression; Risk factors; Cross-sectional studies
Survey on elderly care service needs in Shanghai community with self-developedmeasurement tool
Authors: Yuanyuan Ge, Ji Gu, Bo Gao, Minjie Jin, Ping Lu, Haifeng Yan
Journal: BMJ (2019)

Objective
To survey on the elderly care needs in the community of Shanghai.


Methods
From February 2017 to May 2017, a survey on the elderly care needs was conducted using stratified sampling method among 4 312 residents aged ≥60 years in Malu township of Shanghai Jiading District. The survey involved physical health status (illness, self-care ability, vision, risk of falls), mental health status (expression ability in feelings of self-will/information, comprehension in others′ willingness/information, depression, anxiety), social health status(family care ability), and willingness for elderly care method (self-desires for old-age support, family-desires for old-age support).The survey was implemented by family doctors.


Results
The total demand for elderly care services for the elderly in Malu Township was skewed, with a median score of 9.9 points (5.7, 15.1). In terms of physical health status, 72.7%(3 135) of the elderly suffered from one or more diseases, 90.8%(3 915) of the elderly had good self-care ability, 83.5% (3 600) of the elderly had good eyesight, and 98.5%(4 247) of the elderly had only mild risk of falling; in terms of mental health status, 81.8%(3 527) of the elderly had normal expression ability of self-willingness/information, and 98.3%(4 239) of the elderly had normal understanding ability of wishes/information expressed by others, 87.5%(3 773) of elderly people did not have depression, 97.0%(4 183) of the elderly had no anxiety; in terms of social health, 58.7%(2 531) of elderly people had normal family care ability; 58.7%(2 531) of elderly people were willing to get home-based care, and 53.0%(2 285) of their families also hoped that the elderly could get home-based care.


Conclusion
The needs of elderly care services is at a lower level among old-aged residents in Malu township, however, there is a relatively low social health status. This study provides an objective quantitative basis for the targeted development of medical care and support services for the elderly in the community in the future.


Key words: 
Eged people; Health status; Desires for old-age support; Need
The analysis for prevalence of anxiety and depression and related factors in retired veteran of the armed force
Authors: 孟卫平, 谭平
Journal: BMJ (2005)

目的 探讨军队离退休老年人焦虑、抑郁情绪发生状况及其影响因素.方法采用问卷访问和体格检查相结合的方法,对福州市军队836 名年龄≥60岁老年人的焦虑、抑郁情绪进行流行病学调查,应用SPSS软件系统进行统计分析.结果 836名受试者中检出轻度焦虑296人(35.4%),中重度焦虑58人(6.9%);轻度抑郁336人(40.2%),中重度抑郁63人(7.5%).易出现焦虑、抑郁的年龄段是60 ～ 64岁和75～ 79岁人群.人格特征与焦虑、抑郁明显相关(P<0.01).丧偶、健康状况、经济收入、医疗保健、家庭生活、居住条件是老年人情绪变化的重要因素.结论注重对性格偏差、情绪不稳定老年人的心理干预,加强医疗保健,提高经济改入,增进家庭和睦,有利于减少老年人焦虑、抑郁的发生。
Study of the curative effect of modified tracheal in acute respiratory failure caused by central airway stenosis
Authors: 丘新才, 陈振华, 韦习勋, 梁彩霞
Journal: BMJ (2006)

目的 探讨使用改良气管导管治疗中央气管狭窄引起急性呼吸衰竭的疗效.方法 对16例不同原因造成中央气管狭窄导致急性呼吸衰竭的住院患者,通过胸部X线片、胸部CT以及纤维支气管镜了解中央气管狭窄的部位和范围后,选用合适的硅胶吸引管剪裁制成导管,再经纤维支气管镜引导导管通过狭窄部位,建立人工气管.结果 治疗后患者呼吸困难迅速缓解,动脉血氧分压从(39±12)mm Hg(1 mm Hg=0.133 kPa)增至(72±10)mm Hg,血氧饱和度从(75±13)%增至(95±3)%,动脉血二氧化碳分压则从(102±21)mm Hg下降到(62±13)mm Hg,有效率达100%.除2例气管小量出血外,没有其他严重并发症发生,15例患者存活,1例由于并发严重的多器官功能衰竭而死亡.结论 使用改良气管导管治疗中央气管引起的急性呼吸衰竭,可以短时间内缓解急性呼吸困难,对狭窄的中央气管进行扩张成型,为后续治疗节省了气管球囊扩张术的费用。
临床心身医学服务模式介绍
Authors: 赵旭东
Journal: BMJ (2007)

心身医学是临床工作中很有用的一门交叉边缘学科,可以促进所有专科的医务人员树立整体医学观念,并可转化为他们的日常工作原则和技术,提高医疗服务的水平和质量,进而提高患者生存质量,改进医患关系.各科医师均应结合临床需要来理解、认同新医学模式,主动学习、运用这门新型学科的理论和技术。
Utilizing quantitative multiplex immunofluorescence to characterize paracrine interactions within the tumor-immune landscape of metastatic melanoma.
Authors: Rachel L. Maus, Alexey Leontovich, Raymond Moore, Wendy Kay Nevala, Thomas J. Flotte, Susan Geyer, Ruifeng Guo, Jill Schimke, Betty Ann Dicke, Svetomir Markovic
Journal: Journal of Clinical Oncology (2020)

e15184 Background: Clinical responses to anti-PD1 immunotherapy in patients with metastatic melanoma (MM) remain challenging to predict. This clinical heterogeneity is also reflected in the tumor-immune microenvironment among patients and within a single tumor lesion. With the emergence of multiplex imaging platforms, defining complex phenotypes at single cell resolution has become possible. Here, we sought to objectively quantify paracrine tumor-immune interactions contributing to the variable clinical responses observed in patients receiving anti-PD1 therapy. Methods: Excisional lymph node (LN) biopsies were obtained from treatment-naïve patients with MM who underwent subsequent anti-PD1 therapy. A single 5µm section of LN tissue was used to assess a 42 analyte panel by multiplex immunofluorescence. From 30 LN samples, 418 fields of view (FOVs) were selected resulting in 14,360 high-resolution images of 4 anatomical subregions: tumor core, tumor-immune interface, tumor infiltrate and adjacent immune stroma. Following image processing, we developed an adaptive classification for tumor-centric cellular neighborhoods (TCCN) to identify and quantify critical paracrine interactions within the tumor-immune microenvironment. Results: Stratification based on responsiveness to anti-PD1 therapy resulted in 4 complete responders (CR) and 12 non-responders (NR) at 12-week follow-up. From 126 FOVs, we defined the cellular composition of 197,865 TCCN across patients based on clinical response and LN subregions. Overall, the percentage of TCCN devoid of any T cells, B cells or macrophages was significantly higher in NR compared to CR irrespective of subregion. However, other markers differentiated TCCN based on subregion. Specifically in CR, tumor core regions were enriched for CD8 T cells, while enrichment for B cells and endothelial cells was demonstrated at the tumor-immune interface. Strikingly, tumor infiltrate regions demonstrate robust immune reactivity with enrichment for M1 polarized macrophages, NK cells and B cells in CR compared to NR. Complete data from the 30 patient cohort across 418 FOVs will be presented. Conclusions: Taken together, this data suggests cellular composition of TCCN across subregions of the LN is dynamic within a single metastatic site. In this small cohort, we introduce a formalized stratification to quantify and classify critical paracrine interactions within the immune-tumor microenvironment with the potential to inform clinical responsiveness to therapy.