Department of Dermatology, Venereology and Allergology, Skin Cancer Center Ruhr-University, Ruhr-University Bochum, St Josef Hospital, Gudrunstr. 56, 44791, Bochum, Germany.
Am J Clin Pathol. 2013 May;139(5):566-73. doi: 10.1309/AJCPG83CMAVFBWLC.
Histopathologic differentiation of nevus cell aggregates and metastatic melanoma in lymph nodes is challenging. Patients with melanoma who had undergone sentinel lymph node (SLN) biopsy were evaluated using univariate and multivariate analyses as well as Kaplan-Meier statistics. Of the 651 patients, 50 (7.7%) had a nodal nevus in the SLN. In the logistic regression model, primary melanoma on the lower extremities proved to be the strongest independent negative predictor of nodal nevi with an odds ratio of 0.11 (95% confidence interval, 0.034-0.36; P = .0002). Overall 5-year survival (P = .17) and 5-year disease-free survival (P = .45) of patients with nodal nevi did not significantly differ from that of patients with negative SLNs. The frequency and anatomic localization of nodal nevi observed in the present study are in line with previous studies. Our 5-year survival data clearly demonstrate that nevus cell aggregates in lymph nodes have to be considered a benign condition even though it occurs in patients with melanoma. This study provides an indirect proof of validity and accuracy of current histopathologic methods for differentiation between nodal nevi and melanoma metastasis.
在淋巴结中鉴别痣细胞聚集和转移性黑色素瘤具有挑战性。对接受前哨淋巴结（SLN）活检的黑色素瘤患者进行了单变量和多变量分析以及 Kaplan-Meier 统计分析。在 651 例患者中，50 例（7.7%）的 SLN 中有淋巴结痣。在逻辑回归模型中，下肢的原发性黑色素瘤被证明是淋巴结痣的最强独立负预测因子，优势比为 0.11（95%置信区间，0.034-0.36；P =.0002）。淋巴结痣患者的总体 5 年生存率（P =.17）和 5 年无病生存率（P =.45）与 SLN 阴性患者无显著差异。本研究中观察到的淋巴结痣的频率和解剖定位与先前的研究一致。我们的 5 年生存数据清楚地表明，淋巴结中的痣细胞聚集即使发生在黑色素瘤患者中，也必须被视为良性病变。这项研究为当前区分淋巴结痣和黑色素瘤转移的组织病理学方法的有效性和准确性提供了间接证据。
