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在一项对黑色素瘤患者进行的 10 年回顾性研究中,探讨了消退及其程度和肿瘤浸润淋巴细胞对前哨淋巴结状态、复发和生存的影响。

Influence of regression, its extent and tumor-infiltrating lymphocytes on sentinel node status, relapse, and survival in a 10-year retrospective study of melanoma patients.

机构信息

Dermatology Department.

Pathology Department, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy.

出版信息

Melanoma Res. 2024 Aug 1;34(4):343-349. doi: 10.1097/CMR.0000000000000970. Epub 2024 May 13.

DOI:10.1097/CMR.0000000000000970
PMID:38564432
Abstract

This case-control study seeks to investigate the influence of histological findings, specifically regression, its extent and tumor-infiltrating lymphocyte (TILs), on result of sentinel lymph node (SLN) biopsy, 5-year melanoma-specific survival (MSS), and relapse-free survival (RFS). We included all patients with cutaneous melanoma who underwent SLN biopsy at the Melanoma Center of the University of Brescia, following the Italian Association of Medical Oncology National guidelines from January 2008 to August 2018. Regression and its extent (<75 or ≥75%) and the presence of TILs were reevaluated by a trained dermatopathologist, adhering to the 2017 College of American Pathologists Cancer Protocol for Skin Melanoma. These patients were followed up for 5 years. Our study uncovered significant associations between regression and male sex ( P  < 0.05), melanoma location on the trunk, upper limbs, and back ( P  = 0.001), ulceration ( P  < 0.05), lower Breslow thickness ( P  = 0.001), and the presence of lymphocytic infiltration (both brisk and nonbrisk) ( P  < 0.001). Regression and its extent, however, did not appear to affect SLN positivity ( P  = 0.315). Similarly, our data did not reveal a correlation between TILs and result of SLN biopsy ( P  = 0.256). When analyzing MSS and RFS in relation to the presence or absence of regression and TILs, no statistically significant differences were observed, thus precluding the need for logistic regression and Kaplan-Meier curve analysis. This study's findings underscore that regression and TILs do not appear to exert an influence on sentinel lymph node status, MSS, or RFS in our cohort of patients.

摘要

这项病例对照研究旨在探讨组织学发现,特别是消退及其程度和肿瘤浸润淋巴细胞(TIL)对前哨淋巴结(SLN)活检结果、5 年黑色素瘤特异性生存率(MSS)和无复发生存率(RFS)的影响。我们纳入了所有 2008 年 1 月至 2018 年 8 月期间在布雷西亚大学黑色素瘤中心根据意大利肿瘤内科协会国家指南接受 SLN 活检的皮肤黑色素瘤患者。一名经过培训的皮肤科病理学家对消退及其程度(<75%或≥75%)和 TILs 的存在进行了重新评估,遵循了 2017 年美国病理学家学院皮肤黑色素瘤癌症协议。这些患者随访了 5 年。我们的研究发现,消退与男性性别(P<0.05)、位于躯干、上肢和背部的黑色素瘤位置(P=0.001)、溃疡(P<0.05)、较低的 Breslow 厚度(P=0.001)和淋巴细胞浸润(活跃和不活跃)(P<0.001)之间存在显著相关性。然而,消退及其程度似乎并未影响 SLN 阳性(P=0.315)。同样,我们的数据也没有显示 TILs 与 SLN 活检结果之间存在相关性(P=0.256)。当分析 MSS 和 RFS 与消退和 TILs 的存在与否的关系时,未观察到统计学差异,因此不需要进行逻辑回归和 Kaplan-Meier 曲线分析。本研究的结果表明,在我们的患者队列中,消退和 TILs 似乎不会影响前哨淋巴结状态、MSS 或 RFS。

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