Lymphatic invasion in cutaneous melanoma is associated with sentinel lymph node metastasis
Lymphatic invasion in cutaneous melanoma is associated with sentinel lymph node metastasis
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DOI：
10.1111/j.1600-0560.2008.01166.x
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发表时间：
2009-07-01
影响因子：
1.7
通讯作者：
Dadras, Soheil S.
中科院分区：
文献类型：
--
作者：
Doeden, Katie;Ma, Zhihai;Dadras, Soheil S.
前哨淋巴结（SLN）转移是皮肤黑色素瘤患者分期、预后和临床管理的主要决定因素。然而，淋巴浸润与血管浸润（VI）在SLN扩散中的作用尚不清楚。我们比较了94例黑色素瘤切片中淋巴侵袭（LI）和VI的频率，这些患者平均进行了三年的临床随访，使用免疫染色检测淋巴内皮标志物D2-40 （podoplanin）和LYVE-1以及全血管标志物CD31。LI的发生频率高于VI（分别为16%和3%，p = 0.001），并且与诊断时美国癌症分期联合委员会（American Joint Committee）的评分较高相关（p = 0.0004）。在单因素分析中，LI与SLN转移密切相关（p = 0.008），与肿瘤厚度无关。在多变量分析中，LI并不是SLN转移的重要危险因素。肿瘤内淋巴管（ITLs）的存在与远处转移有关，而VI是罕见的，与SLN或远处转移无关。与常规组织学和vi相比，LI联合ITL对SLN转移风险的阳性和阴性预测价值更高。在原发肿瘤中检测LI可能有助于识别有SLN转移倾向的黑色素瘤患者。引用本文：张建军，张建军，张建军，张建军。皮肤黑色素瘤的淋巴浸润与前哨淋巴结转移的关系。中华病毒学杂志2009；36: 772 - 780。(C) 2008 John Wiley & Sons A/S。
Sentinel lymph node (SLN) metastasis is a major determinant for staging, prognostication and clinical management of patients with cutaneous melanoma. However, the role of lymphatic vs. vascular invasion (VI) for SLN spread remains unclear.We compared the frequency of lymphatic invasion (LI) vs. VI in melanoma sections from 94 patients with a mean three-year clinical follow up using immunostains for the lymphatic endothelial markers D2-40 (podoplanin) and LYVE-1 and the panvascular marker CD31.LI occurred more frequently than VI (16 vs. 3%, respectively, p = 0.001) and correlated with higher American Joint Committee on Cancer stage at diagnosis (p = 0.0004). In a univariate analysis, LI was strongly associated with SLN metastasis (p = 0.008), independent of tumor thickness. In a multivariate analysis, LI was not a significant risk factor for SLN metastasis. The presence of intratumoral lymphatics (ITLs) was associated with distant metastasis, whereas VI was rare and did not correlate with SLN or distant metastasis. A combination of LI and ITL had higher positive and negative predictive values for the risk of developing SLN metastasis compared with routine histology and VI.Detection of LI in the primary tumor may aid in identifying melanoma patients with the propensity to develop SLN metastasis.Doeden K, Ma Z, Narasimhan B, Swetter AM, Detmar M, Dadras SS. Lymphatic invasion in cutaneous melanoma is associated with sentinel lymph node metastasis.J Cutan Pathol 2009; 36: 772-780. (C) 2008 John Wiley & Sons A/S.