Tumor infiltrating lymphocytes in acral lentiginous melanoma: a study of a large cohort of cases from Latin America
Tumor infiltrating lymphocytes in acral lentiginous melanoma: a study of a large cohort of cases from Latin America
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DOI：
10.1007/s12094-017-1685-3
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发表时间：
2017-12-01
影响因子：
3.4
通讯作者：
Abugattas, J.
中科院分区：
文献类型：
--
作者：
Castaneda, C. A.;Torres-Cabala, C.;Abugattas, J.
肢端雀斑样黑色素瘤（ALM）是一种预后不良的亚型，在非高加索人群中最常见。肿瘤浸润淋巴细胞（TIL）的存在与黑色素瘤的预后不良有关。对2005年至2012年在秘鲁国家肿瘤研究所就诊的所有皮肤黑色素瘤患者进行回顾性鉴定。从病历中获得临床病理信息。对TIL进行了前瞻性评价。分析ALM和临床病理特征（包括TIL）之间的相关性以及生存分析，比较ALM与整个组和肢体NALM的结局。研究了824例皮肤黑色素瘤病例中的537例ALM。发现在ALM中年龄较大（p = 0.022）、较高的Breslow（p = 0.008）和溃疡（p < 0.001）更常见。Acral组的总生存率（OS）低于全组（p = 0.04）。临床分期（CS）I-II期患者的中位OS为5.3（95% CI 4.3-6.2）（ALM）和9.2（95% CI 5.0-7.0）（肢体NALM）（p = 0.016）。0级（无TIL）、I级、II级和III级分别为7.5%、34.5%、32.1%和25.9%。较低的TIL分级与较大的肿瘤大小相关（p = 0.003），Breslow较高（p = 0.001），克拉克水平较高（p = 0.007），CS较高（p = 0.002），肢体位置（p = 0.048）、组织学亚型ALM（p = 0.024）和更好的OS（p = 0.001）JLM在秘鲁高度流行并且具有差的结果。较低的TIL水平与不良结局和ALM相关。
Acral lentiginous melanoma (ALM) is a poor prognosis subtype and is the most prevalent in non-Caucasian populations. The presence of tumor infiltrating lymphocytes (TILs) has been associated with poor prognosis in melanoma. A large cohort of ALM cases was studied to determine status of TIL and its association with outcome.All patients with cutaneous melanoma presenting from 2005 to 2012 at Instituto Nacional de Enfermedades Neoplasicas in Peru were retrospectively identified. Clinicopathological information was obtained from the medical charts. A prospective evaluation of TIL was performed. Analysis of association between ALM and clinicopathological features including TIL as well as survival analysis compared the outcome of ALM to whole group and extremity NALM was performed.537 ALM from a total of 824 cutaneous melanoma cases were studied. Older age (p = 0.022), higher Breslow (p = 0.008) and ulceration (p < 0.001) were found to be more frequent in ALM. Acral had worse overall survival (OS) compared with the whole group (p = 0.04). Clinical stage (CS) I-II patients had a median OS of 5.3 (95% CI 4.3-6.2) for ALM and 9.2 (95% CI 5.0-7.0) for extremity NALM (p = 0.016). Grade 0 (absence of TIL), I, II and III were found in 7.5, 34.5, 32.1, and 25.9%, respectively. Lower TIL grade was associated with larger tumor size (p = 0.003), higher Breslow (p = 0.001), higher Clark level (p = 0.007), higher CS (p = 0.002), extremity location (p = 0.048), histological subtype ALM (p = 0.024) and better OS (p = 0.001).ALM is highly prevalent in Peru and carries poor outcome. Lower TIL levels were associated with poor outcome and ALM.