Department of Surgery, Mayo Clinic, Rochester, Minnesota.
Department of Surgery, Mayo Clinic, Scottsdale, Arizona.
J Surg Oncol. 2020 Nov;122(6):1043-1049. doi: 10.1002/jso.26135. Epub 2020 Jul 22.
Benign capsular nevi (BCN) are not infrequent in sentinel lymph nodes (SLN) of patients with melanoma. Their prognostic significance is unknown and the literature is limited. This study evaluated the clinical significance of incidentally found BCN in these patients.
A multi-institutional retrospective review of patients undergoing SLN biopsy for cutaneous melanoma between 2000 and 2016. Patients were divided into the following groups: (a) negative SLN and no BCN, (b) negative SLN and presence of BCN, (c) positive SLN seen only on immunohistochemistry (IHC), and (d) positive SLN via hematoxylin and eosin (H&E). Outcomes measured were overall survival and any recurrence.
A total of 1253 patients were identified (group 1 = 978, group 2 = 56, group 3 = 32, and group 4 = 187). Fifty-seven percent were male and the mean age was 59.3 years. BCN was identified in 77 patients (6.2%), of which the majority was in the node-negative group (72%). Multivariable analysis showed that BCN was associated with lower recurrence rates, though not statistically significant (hazard ratio [HR] = 0.5; P = .06). IHC- and H&E-positive SLNs were associated with a higher risk of recurrence (HR = 2.4; P = .02 and 2.0, P < .0001, respectively).
Patients with BCN and negative SLN had lower recurrence rates than patients with negative SLN and no BCN. Our data suggest a possible protective effect against recurrence.
良性囊状神经鞘瘤（BCN）在黑色素瘤患者的前哨淋巴结（SLN）中并不少见。其预后意义尚不清楚，文献有限。本研究评估了这些患者中偶然发现的 BCN 的临床意义。
对 2000 年至 2016 年间接受 SLN 活检的皮肤黑色素瘤患者进行多机构回顾性分析。患者分为以下几组：（a）阴性 SLN 且无 BCN，（b）阴性 SLN 且存在 BCN，（c）仅通过免疫组织化学（IHC）可见阳性 SLN，和（d）通过苏木精和伊红（H&E）可见阳性 SLN。测量的结果是总生存率和任何复发率。
共确定了 1253 例患者（组 1=978，组 2=56，组 3=32，组 4=187）。57%为男性，平均年龄为 59.3 岁。在 77 例患者（6.2%）中发现了 BCN，其中大多数位于阴性淋巴结组（72%）。多变量分析显示，BCN 与较低的复发率相关，但无统计学意义（风险比[HR]=0.5；P=0.06）。IHC 和 H&E 阳性 SLN 与更高的复发风险相关（HR=2.4；P=0.02 和 2.0，P<0.0001，分别）。
BCN 且阴性 SLN 的患者比阴性 SLN 且无 BCN 的患者复发率更低。我们的数据表明，BCN 可能对复发有保护作用。
