The use of LYVE-1 antibody for detecting lymphatic involvement in patients with malignant melanoma of known sentinel node status
The use of LYVE-1 antibody for detecting lymphatic involvement in patients with malignant melanoma of known sentinel node status
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DOI：
10.1136/jcp.2004.020123
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发表时间：
2005-07-01
影响因子：
3.4
通讯作者：
Russell-Jones, R
中科院分区：
文献类型：
--
作者：
Sahni, D;Robson, A;Russell-Jones, R
背景资料：前哨淋巴结（SN）状态是皮肤黑色素瘤患者最重要的预后指标，而临床上没有明显的转移扩散，但该程序与相当大的发病率。LYVE-1淋巴标记物提供了研究淋巴管生成和肿瘤转移的可能性，在原发性excitation.Aims：建立是否淋巴管数量/分布在原发性肿瘤与SN状态相关。为了评估肿瘤细胞是否容易在血管内显示，并可用作SN状态的替代物，方法：对18例SN+患者的皮肤活检组织进行LYVE-1和S100双重免疫染色，常规组织学检查无淋巴/血管受累，18例SN-患者的肿瘤厚度和溃疡相匹配。肿瘤内的血管提示活跃的淋巴管生成;肿瘤外的血管主要是成熟的血管，血管壁清晰。在18名SN-患者中的1名和18名SN+患者中的5名中检测到肿瘤细胞。含有肿瘤细胞的淋巴管都在肿瘤块外的成形良好的血管中，表明黑色素瘤细胞侵入预先形成的淋巴管。SN+和SN-患者之间的淋巴计数无显著差异。虽然溃疡性黑色素瘤的瘤周淋巴管计数高于非溃疡性黑色素瘤，但它们并不随Breslow thickness.Conclusion：LYVE-1染色可以可靠地显示淋巴管分布，但淋巴管计数不能预测黑色素瘤的转移潜力，不能代替SN活检。LYVE-1免疫染色可以检测到淋巴结内的黑色素瘤细胞，但在预测黑色素瘤转移方面不可靠，在超过三分之二的区域淋巴结转移患者中未能检测到转移扩散。
Background: Sentinel node (SN) status is the most important prognostic indicator in patients with cutaneous melanoma without clinically evident metastatic spread, but the procedure is associated with considerable morbidity. The LYVE-1 lymphatic marker offers the possibility of studying lymphangiogenesis and tumour metastasis within the primary excision.Aims: To establish whether lymphatic vessel numbers/distribution within the primary tumour correlated with SN status. To assess whether tumour cells were easily demonstrable within lymphatics and could be used as a surrogate for SN status.Methods: Double immunostaining for LYVE-1 and S100 in cutaneous biopsies from 18 SN+ patients with no lymphatic/vascular involvement on routine histology and 18 SN- patients matched for tumour thickness and ulceration.Results: Lymphatic vessels were detected in all cases. Vessels within the tumour mass were suggestive of active lymphangiogenesis; those outside were mainly mature vessels with well defined walls. Tumour cells within lymphatics were detected in one of 18 SN- and five of 18 SN+ patients. Lymphatics containing tumour cells were all outside the tumour mass in well formed vessels, suggesting melanoma cell invasion into preformed lymphatics. There was no significant difference in lymphatic counts between SN+ and SN- patients. Although peritumorous lymphatic counts were higher in ulcerated than non-ulcerated melanomas, they did not vary with Breslow thickness.Conclusion: LYVE-1 staining can reliably demonstrate lymphatic vessel distribution, but lymphatic counts cannot predict melanoma metastatic potential and cannot substitute for SN biopsy. LYVE-1 immunostaining can detect melanoma cells within lymphatics, but is unreliable in predicting melanoma metastasis, failing to detect metastatic spread in more than two thirds of patients with regional node metastasis.