The prognostic value of a reverse transcriptase-PCR assay of sentinel lymph node biopsy for patients with cutaneous melanoma: a single-center analysis in Japan
The prognostic value of a reverse transcriptase-PCR assay of sentinel lymph node biopsy for patients with cutaneous melanoma: a single-center analysis in Japan
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DOI：
10.1097/cmr.0b013e32834dcfdf
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发表时间：
2012-02-01
影响因子：
2.2
通讯作者：
Furue, Masutaka
中科院分区：
文献类型：
--
作者：
Ito, Takamichi;Moroi, Yoichi;Furue, Masutaka
前哨淋巴结活检（SLNB）是黑色素瘤分期的标准治疗。然而，在亚洲国家，SLNB对原发性皮肤黑色素瘤患者的预后价值的研究有限。目的是评估SLNB在日本原发性皮肤黑色素瘤患者中的疗效，并阐明前哨淋巴结（SLN）的逆转录酶（RT）-PCR分析是否对预测患者预后有价值。2001年5月至2009年12月期间，共有101例原发性皮肤黑色素瘤患者在九州大学皮肤科（日本福冈）接受SLNB。切除的淋巴结用苏木精-伊红染色，并用HMB-45、酪氨酸酶、MART-1和MITF的免疫组织化学染色，并进行多mRNA标记物（MART-1、酪氨酸酶和GP-100）RT-PCR测定。评估以下临床病理学变量：年龄、性别、组织学类型、肿瘤部位、Breslow厚度、无病生存期（DFS）和黑色素瘤特异性生存期（MSS）。使用Kaplan-Meier方法和考克斯比例风险模型分析DFS和MSS的几个参数。SLN的识别率为98%（99/101）。肿瘤阳性SLN与较高的Breslow厚度、分期、肿瘤亚型和肿瘤部位显著相关。肿瘤阳性SLN患者的MSS和DFS显著短于肿瘤阴性SLN患者（P分别为0.0153和0.0004）。在RT-PCR检测中至少有两个阳性标志物的患者的DFS显著短于那些少于一个标志物的患者（P = 0.013）。SLNB和多标记RT-PCR分析对判断黑色素瘤患者的预后有重要意义。黑色素瘤研究22：38-44（C）2012年沃尔特斯Kluwer健康垂直酒吧Lippincott威廉姆斯&威尔金斯。
Sentinel lymph node biopsy (SLNB) is the standard of care for staging melanoma. However, limited research has been carried out on the prognostic value of SLNB in patients with primary cutaneous melanoma in Asian countries. The objective is to evaluate the efficacy of SLNB in Japanese patients with primary cutaneous melanoma and to elucidate whether reverse transcriptase (RT)-PCR analysis of sentinel lymph nodes (SLNs) is valuable for predicting patient outcome. A total of 101 patients with primary cutaneous melanoma underwent SLNB at the Department of Dermatology, Kyushu University (Fukuoka, Japan), between May 2001 and December 2009. The removed nodes were stained with hematoxylin-eosin and with immunohistochemical stains for HMB-45, tyrosinase, MART-1, and MITF and multiple-mRNA marker (MART-1, tyrosinase, and GP-100) RT-PCR assays were conducted. The following clinicopathological variables were evaluated: age, sex, histological type, tumor site, Breslow thickness, disease-free survival (DFS), and melanoma-specific survival (MSS). Several parameters were analyzed for DFS and MSS using the Kaplan-Meier method and Cox proportional hazards model. The success rate of identifying SLNs was 98% (99 of 101 cases). Tumor-positive SLNs were significantly correlated with higher Breslow thickness, stage, tumor subtype, and tumor site. Patients with tumor-positive SLNs had a significantly shorter MSS and DFS than those with tumor-negative SLNs (P = 0.0153 and 0.0004, respectively). Patients with at least two positive markers in the RT-PCR assay had a significantly shorter DFS than those with less than one marker (P = 0.013). SLNB and multimarker RT-PCR analysis are useful for predicting the prognosis of patients with melanoma. Melanoma Res 22: 38-44 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.