Tumor lymphangiogenesis predicts melanoma metastasis to sentinel lymph nodes
Tumor lymphangiogenesis predicts melanoma metastasis to sentinel lymph nodes
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DOI：
10.1038/modpathol.3800410
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发表时间：
2005-09-01
期刊：
影响因子：
7.5
通讯作者：
Detmar, M
中科院分区：
文献类型：
--
作者：
Dadras, SS;Lange-Asschenfeldt, B;Detmar, M
皮肤黑色素瘤是一种常见的黑色素细胞肿瘤，可快速转移至区域淋巴结。目前，预后是通过测量肿瘤厚度来确定的，但迫切需要更可靠的转移扩散标志物。我们研究了肿瘤淋巴管生成的程度是否可以预测黑色素瘤转移至前哨淋巴结。我们量化了 45 名原发性皮肤黑色素瘤患者的切除原发性肿瘤和前哨淋巴结活检样本中肿瘤淋巴管生成的程度以及其他因素。结果与组织学和临床结果相关。与非转移性肿瘤相比，肿瘤已转移至前哨淋巴结的患者的原发性黑色素瘤含有明显的淋巴管密度增加的“热点”。多变量风险分析显示，原发性黑色素瘤的淋巴管面积（肿瘤淋巴管生成的指标）是前哨淋巴结转移最敏感的预后标志物，甚至比目前使用的测量肿瘤厚度的方法更准确地预测哪些肿瘤转移至前哨淋巴结。高度淋巴管生成的黑色素瘤在转移至前哨淋巴结后仍保持其淋巴管生成活性。肿瘤淋巴管生成的程度是淋巴结转移的高度敏感（83％）和特异性（89％）的预后标志。在选择早期转移性疾病患者进行积极治疗时，评估原发性黑色素瘤中的淋巴管生成可能是比目前使用的测量肿瘤厚度的技术更有效的方法。
Cutaneous melanoma is a common melanocytic neoplasm that can quickly metastasize to regional lymph nodes. Currently, prognosis is determined by measuring tumor thickness but more reliable markers for metastatic spread are urgently needed. We investigated whether the extent of tumor lymphangiogenesis can predict melanoma metastasis to sentinel lymph nodes. We quantified the extent of tumor lymphangiogenesis, as well as other factors, in excised primary tumors and in sentinel lymph node biopsy samples from 45 patients with primary cutaneous melanoma. The results were correlated with histological and clinical outcome. Primary melanomas from patients whose tumors had metastasized to the sentinel lymph nodes contained prominent 'hot spots' of increased lymphatic vessel density, compared to nonmetastatic tumors. Multivariate risk analysis revealed that the lymphatic vascular area of primary melanomas, an index of tumor lymphangiogenesis, was the most sensitive prognostic marker for sentinel lymph node metastasis, and was even able to more accurately predict which tumors were metastatic to sentinel lymph nodes than the currently used method of measuring tumor thickness. Highly lymphangiogenic melanomas maintained their lymphangiogenic activity after metastasis to the sentinel lymph node. The extent of tumor lymphangiogenesis is a highly sensitive (83%) and specific (89%) prognostic marker of lymph node metastasis. Assessment of lymphangiogenesis in primary melanomas may be a more effective approach than the currently used technique of measuring tumor thickness in selecting patients with early metastatic disease for aggressive therapy.