Department of Dermatopathology, University Hospital of Liège, Liège, Belgium.
Am J Clin Dermatol. 2011 Apr 1;12(2):77-86. doi: 10.2165/11318380-000000000-00000.
Malignant melanoma (MM) micrometastases are basically seen in three locations inside the peritumoral dermis. They are localized (i) inside the interstitial sector of the dermal stroma; (ii) abutted to the external surface of the microvasculature; and (iii) more rarely present inside vascular channels. Single-cell and paucicellular micrometastases may be disclosed using immunohistochemistry even in the absence of larger microsatellites, which represent micronodular nests of metastatic cells. The presence of microsatellites is frequently tied to markers of MM aggressiveness including thickness and the Ki-67 index. Micrometastases may be present in the same conditions, but even as early as thin MM showing a small growth fraction. Microsatellites as well as micrometastases appear to predict locoregional extension and decreased relapse-free interval, but not distant metastasis and overall survival. These considerations have implications for patient care since patients with microsatellites and micrometastases are now included in the clinical stage III category of the disease. Their implication as a prognostic factor is not fully dependent on or linked to other markers of MM aggressiveness.
恶性黑色素瘤（MM）微转移主要见于肿瘤周围真皮内三个部位。它们定位于（i）真皮基质间质区内；（ii）紧靠微血管的外表面；和（iii）更罕见地存在于血管内。即使在没有更大微卫星的情况下，使用免疫组织化学也可以揭示单细胞和少量细胞微转移，微卫星代表转移性细胞的微结节巢。微卫星的存在通常与 MM 侵袭性的标志物相关，包括厚度和 Ki-67 指数。微卫星可能在相同的情况下存在，但即使在表现出小生长分数的早期薄 MM 中也可能存在。微卫星和微转移似乎可预测局部区域扩展和复发间隔时间缩短，但不能预测远处转移和总生存期。这些考虑对患者护理有影响，因为现在有微卫星和微转移的患者被归入疾病的临床 III 期类别。它们作为预后因素的意义不完全取决于或与 MM 侵袭性的其他标志物相关。
