Lee Seok-Jong, Lim Hyun Jung, Choi Yoon Hyuk, Chang Yong Hyun, Lee Weon Ju, Kim Do Won, Yoon Ghil Suk
Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea.
Ann Dermatol. 2013 Feb;25(1):61-6. doi: 10.5021/ad.2013.25.1.61. Epub 2013 Feb 14.
There are various histological prognostic parameters of cutaneous malignant melanoma, including tumor thickness and ulceration. Tumor-infiltrating lymphocytes (TIL) are among these parameters and can be further classified into three categories: 'absent', 'non-brisk' and 'brisk'. Brisk TIL usually indicates better clinical prognosis. Microscopic satellite (Ms) is defined as a nest of tumor cells that is greater than 0.05 mm in diameter and definitely separated from the main tumor. Even though the incidence of Ms varies according to Breslow thickness, the presence of Ms generally indicates poor prognosis.
Clinical significance of both TIL and Ms has been extensively studied in western populations but much less so in Asian countries, including Korea, where acral melanoma is the most common subtype.
We reviewed 90 patients with acral melanoma diagnosed at Kyungpook National University Hospital in Korea. Tissue specimens were examined using hematoxylin-eosin and HMB45 immunohistochemical staining. They were also evaluated by the presence and categorization of TIL (absent, non-brisk and brisk) and the presence of Ms. We further evaluated their impact on survival events (recurrence, distant metastasis and death).
The number of survival events by TIL type was 22 in the absent category (22/64, 34.4%), 3 in the non-brisk category (3/25, 12.0%) and 0 in the brisk category. For Ms, survival events were present in 7 patients in Ms-present group (7/11, 63.6%) and 21 patients in Ms-absent group (21/79, 26.6%).
We suggest the possibility of TIL and Ms as prognostic indicators for acral melanoma in Korean population.
皮肤恶性黑色素瘤有多种组织学预后参数，包括肿瘤厚度和溃疡情况。肿瘤浸润淋巴细胞（TIL）是这些参数之一，可进一步分为三类：“无”“不活跃”和“活跃”。活跃的TIL通常提示较好的临床预后。微小卫星灶（Ms）定义为直径大于0.05 mm且与主肿瘤明确分离的肿瘤细胞巢。尽管Ms的发生率因Breslow厚度而异，但Ms的存在通常提示预后不良。
TIL和Ms的临床意义在西方人群中已得到广泛研究，但在包括韩国在内的亚洲国家研究较少，在韩国肢端黑色素瘤是最常见的亚型。
我们回顾了韩国庆北国立大学医院诊断的90例肢端黑色素瘤患者。组织标本采用苏木精-伊红染色和HMB45免疫组化染色进行检查。还根据TIL的存在情况及分类（无、不活跃和活跃）以及Ms的存在情况对其进行评估。我们进一步评估了它们对生存事件（复发、远处转移和死亡）的影响。
按TIL类型划分的生存事件数量，“无”类别中有22例（22/64，34.4%），“不活跃”类别中有3例（3/25，12.0%），“活跃”类别中为0例。对于Ms，Ms存在组有7例生存事件（7/11，63.6%），Ms不存在组有21例生存事件（21/79，26.6%）。
我们认为TIL和Ms有可能作为韩国人群肢端黑色素瘤的预后指标。
