背景:淋巴管浸润(LVI)被认为是黑素瘤细胞可以扩散到区域淋巴结和远处部位的机制,并且可能是不良结果的预测因素。在苏木精-伊红(HE)染色的切片上通常很难检测到淋巴管浸润,容易用双重免疫组织化学(IHC)鉴定黑素细胞和血管标志物。
方法:纳入100例Breslow厚度为1-4mm且常规HE评估缺乏LVI的原发性皮肤恶性黑色素瘤病例。我们比较了CD31/S100和CD34/S100以及D2-40/S100双重染色的LVI检出率,并检查了LVI与临床结果的关联。
结果:CD31/S100,CD34/S100和D2-40/S100的双重免疫组织化学阳性为40(40%),17(17%)和35(35%),分别。在多变量分析中,LVI是SLN状态的独立预测因子。多因素分析显示,LVI和男性是影响总生存的独立危险因素。
结论:双重IHC改善了LVI的识别,并预测了SLN转移。使用双IHC检测LVI,特别是通过CD31/S100和D2-40/S100的组合是一个有用的步骤,建议将其纳入皮肤黑色素瘤的基本评估参数中。
BACKGROUND: Lymphovascular invasion (LVI) is believed to be the mechanism by which melanoma cells can disseminate to regional lymph nodes and distant sites and may be predictive of adverse outcome. Lymphovascular invasion often difficult to detect on hematoxylin-eosin (HE) stained sections, are readily identified with dual immunohistochemistry (IHC) for melanocytic and vascular markers.
METHODS: A total of 100 primary cutaneous malignant melanoma cases that had a Breslow thickness of 1-4 mm and lacked LVI by conventional HE assessment were included. We compared the LVI detection rates of double staining for CD31/S100 and CD34/S100, and D2-40/S100, and examined the association of LVI with clinical outcomes.
RESULTS: The dual immunohistochemical positivity for CD31/S100, CD34/S100, and D2-40/S100 were 40(40%), 17(17%) and 35(35%), respectively. On multivariate analysis, LVI was an independent predictor of SLN status. Multivariate analysis revealed that LVI and male gender were independent risk factors for overall survival.
CONCLUSIONS: The recognition of LVI is improved by dual IHC and predicts SLN metastasis. The detection of LVI using dual IHC, especially by a combination of CD31/S100 and D2-40/S100 is a useful step that inclusion should be recommended in basic evaluation parameters for cutaneous melanoma.