Oesophagogastric cancer remains a significant health concern worldwide with a very poor prognosis and limited therapy options. The host anti-tumour response largely depends on the activation of T cells and B cells in tumour draining lymph nodes (LN) initiated by tumour antigen presenting dendritic cells. Any immune response activation in LN leads to an increase in LN size and microarchitectural changes such as paracortical hyperplasia, follicular hyperplasia or sinus histiocytosis. For decades, pathologists are looking at LNs of cancer resection specimens in order to identify and count LN with tumour metastasis. Yet, the microarchitectural features visible in tumour negative LN, most likely indicative of the host's ability to mount an anti-tumour response and their potential predictive/prognostic value has not been studied in detail in patients with OeG cancers. This lecture will first provide a brief overview of how the host anti-tumour reaction in patients with cancer works and then discuss the potential clinical importance of our own recent quantitative results from LN microarchitecture studies in OeG resection specimens from patients treated either by neoadjuvant chemotherapy or surgery alone. In the second part of the lecture, results from relating the LN microarchitectureal features to the primary tumour microenvironment (tumour stroma content, tumour infiltrating lymphocytes) in OeG will be presented. The potential implications of our findings for clinical practice and future research directions will be discussed.
 

In recent years, advanced molecular techniques, including single-cell sequencing and spatial transcriptomics, alongside artificial intelligence, have revolutionized tissue-based biomarker research. Yet, conventional histopathology remains the cornerstone of routine diagnostic practice. Focusing on gastrointestinal cancers, particularly stomach and bowel cancer, this invited lecture underscores the enduring value of conventional histopathology amidst these cutting-edge advancements.
 

Artificial intelligence is poised to revolutionise GI pathology with advancements in clinical support tools and predictive models. Despite the widespread discussion of AI, only a few pathologists currently have access to these tools. This talk will examine the current state of AI in GI pathology, showcasing its benefits in improving diagnostic accuracy and efficiency but also highlighting challenges of implementation.