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. 2021 Sep 29;10(10):2585. doi: 10.3390/cells10102585

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© 2021 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Mechanisms of tumor lymphatic invasion. (A) Schematic representation of progression from an in situ to an invasive carcinoma, breaching the basement membrane (BM) and growing into the underlying tissue where lymphatic vessels (LV) are located. Tumor cells can get access to lymphatic vessels by pushing growth of the tumor mass; induction of lymphangiogenesis in or around the tumor; single-cell tissue infiltration; and collective tissue infiltration. (B) Tumor cells can invade lymphatic vessels by (1) mechanical damage or disruption of the lymphatic endothelial wall; (2) by sensing CCL21 gradients and intravasation via lymphatic endothelial flap junctions; (3) by inducing lymphatic permeability, e.g., through cytokine- or growth factor (GF)-induced upregulation of α4β1 integrin and its ligand VCAM-1 in LECs; (4) via release of chemorepulsive agents (e.g., 12(S)-HETE) that induce LEC retraction and formation of invasion portals (CCIDs).