Department of Pathology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Department of Biostatistics, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Hum Pathol. 2018 Jul;77:98-107. doi: 10.1016/j.humpath.2018.03.017. Epub 2018 Mar 28.
Primary cutaneous Merkel cell carcinoma (MCC) is an aggressive neuroendocrine malignancy in which lymphovascular invasion (LVI) correlates with more aggressive phenotype. The prognostic significance of LVI detected by D2-40 immunohistochemistry (IHC) in MCC remains controversial. We aimed to determine how LVI detected by D2-40 IHC compares with LVI detected by hematoxylin and eosin (H&E) staining in predicting MCC metastasis. Clinical and histopathologic features of MCCs diagnosed and treated in 2002 to 2015 were assembled and included 58 MCC tumors from 58 patients. H&E-stained tissue sections and D2-40 IHC studies were reviewed. When LVI was present, the location (peritumoral or intratumoral) and the size of the largest invaded vessel were recorded. LVI findings by H&E staining and D2-40 IHC were compared with each other and with histologic features and clinical outcomes. H&E staining showed LVI in 37 of 58 cases; D2-40 IHC confirmed LVI in 30 of these cases but failed to confirm LVI in 7. D2-40 IHC also detected 14 cases of LVI not identified on H&E staining. Histologically, D2-40-detected LVI was associated with infiltrative growth pattern and nonbrisk lymphoid infiltrate (P = .005 and P = .055, respectively). There was a statistically significant difference between the frequency of detection of peritumoral LVI by H&E in comparison to D2-40 IHC (P = .0009). MCCs in which D2-40 IHC-detected both intratumoral and peritumoral LVI were typically larger than MCCs without (mean, 24.5 mm versus 17.3 mm; P = .03) and more frequently metastasized (87% versus 51%; P = .03). D2-40 IHC detection of both intratumoral and peritumoral LVI is associated with metastasis.
原发性皮肤 Merkel 细胞癌（MCC）是一种侵袭性神经内分泌恶性肿瘤，其中淋巴血管侵犯（LVI）与更具侵袭性的表型相关。D2-40 免疫组化（IHC）检测到的 LVI 在 MCC 中的预后意义仍存在争议。我们旨在确定 D2-40 IHC 检测到的 LVI 与苏木精和伊红（H&E）染色检测到的 LVI 在预测 MCC 转移方面的比较。收集了 2002 年至 2015 年诊断和治疗的 MCC 患者的临床和组织病理学特征，共包括 58 例患者的 58 例 MCC 肿瘤。对 H&E 染色组织切片和 D2-40 IHC 研究进行了回顾。当存在 LVI 时，记录其位置（肿瘤周围或肿瘤内）和最大侵袭血管的大小。比较 H&E 染色和 D2-40 IHC 的 LVI 结果，并与组织学特征和临床结果进行比较。H&E 染色显示 58 例中有 37 例存在 LVI；D2-40 IHC 在这些病例中确认了 30 例存在 LVI，但未能确认 7 例存在 LVI。D2-40 IHC 还检测到 14 例 H&E 染色未发现的 LVI。组织学上，D2-40 检测到的 LVI 与浸润性生长模式和非活跃性淋巴浸润有关（分别为 P=0.005 和 P=0.055）。与 H&E 相比，D2-40 IHC 检测到肿瘤周围 LVI 的频率存在统计学差异（P=0.0009）。D2-40 IHC 检测到肿瘤内和肿瘤周围 LVI 的 MCC 通常比没有 LVI 的 MCC 更大（平均大小，24.5mm 与 17.3mm；P=0.03），并且更常转移（87%与 51%；P=0.03）。D2-40 IHC 检测到肿瘤内和肿瘤周围 LVI 与转移有关。
