Micciolo Rocco, Boi Sebastiana, Paoli Loredana, Cristofolini Paolo, Girlando Salvatore, Dalla Palma Paolo, Cristofolini Mario
Department of Sociology and Social Research, Trento University, Trento, Italy.
Tumori. 2009 May-Jun;95(3):298-302. doi: 10.1177/030089160909500305.
The presence of nodal metastases in patients with primary cutaneous melanoma adversely affects the biological behavior and is related to a poor prognosis. The role of sentinel lymph node biopsy is still debated. The aim of this study was to evaluate the prognostic role of sentinel lymph node biopsy with respect to disease-free period and overall survival.
Patients with invasive cutaneous melanoma who underwent sentinel lymph node biopsy in the Santa Chiara Hospital of Trento between October 1997 and December 2002 were evaluated. The lymph nodes were examined with conventional histology, S100 and tyrosinase in immunohistochemistry, and tyrosinase in molecular biology.
There were 144 patients with 198 sentinel lymph nodes. A significant association was found in conventional histology with Clark level and Breslow thickness. The prognostic role of sentinel lymph node status was independent of the other considered variables. However, no significant association was found with the molecular biology test. A significant excess of positive results at molecular biology was found.
Sentinel lymph node biopsy is an important independent prognostic factor for invasive cutaneous melanoma, but only when evaluated with conventional histology. As a result of this study, we stopped performing the tyrosinase test in molecular biology.
原发性皮肤黑色素瘤患者出现淋巴结转移会对生物学行为产生不利影响，并与预后不良相关。前哨淋巴结活检的作用仍存在争议。本研究的目的是评估前哨淋巴结活检在无病生存期和总生存期方面的预后作用。
对1997年10月至2002年12月期间在特伦托圣基亚拉医院接受前哨淋巴结活检的浸润性皮肤黑色素瘤患者进行评估。采用常规组织学、免疫组织化学中的S100和酪氨酸酶以及分子生物学中的酪氨酸酶对淋巴结进行检查。
144例患者共198个前哨淋巴结。在常规组织学中发现与克拉克分级和布雷斯洛厚度存在显著关联。前哨淋巴结状态的预后作用独立于其他所考虑的变量。然而，与分子生物学检测未发现显著关联。分子生物学检测结果呈阳性的情况明显过多。
前哨淋巴结活检是浸润性皮肤黑色素瘤的一个重要独立预后因素，但仅在采用常规组织学评估时如此。基于本研究结果，我们停止了分子生物学中的酪氨酸酶检测。
