Ronchi Andrea, D'Abbronzo Giuseppe, Carraturo Emma, Argenziano Giuseppe, Brancaccio Gabriella, Scharf Camila, Moscarella Elvira, Troiani Teresa, Iovino Francesco, Tolone Salvatore, Faenza Mario, Cazzato Gerardo, Franco Renato
Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 81100 Naples, Italy.
Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 81100 Naples, Italy.
Diagnostics (Basel). 2024 Dec 30;15(1):69. doi: 10.3390/diagnostics15010069.
: This study aims to evaluate whether the presence of isolated tumor cells (ITCs) correlates with specific stages of cutaneous melanoma, potentially shedding light on their prognostic significance and the paradoxical survival outcomes in stage IIIA. : This study analyzed cases of sentinel lymph node biopsies for cutaneous melanoma between 2021 and 2023. It included patients with CM diagnoses, available histological slides, and clinical information about the neoplasia stage. The correlation between the primary tumor stage and the presence of isolated tumor cells was statistically analyzed. : This study analyzed 462 sentinel lymph node biopsies, revealing 77.1% negative cases and 22.9% positive cases. Isolated tumor cells were observed in 24 cases (5.2%), most commonly in the early stages (e.g., pT1b and pT2a). Statistical analysis confirmed a significant correlation between ITC presence and early-stage neoplasms ( = 0.014). : Although ITCs prompt upstaging, their prognostic impact appears limited, especially in thin melanomas, where survival aligns more closely with stage IB than stage IIIA. This aligns with findings from breast cancer studies where ITCs are not equated to metastases in staging due to their minimal impact on prognosis. Current melanoma staging practices could benefit from differentiating ITCs from larger metastatic deposits to better reflect the actual metastatic burden and guide treatment decisions.
本研究旨在评估孤立肿瘤细胞（ITCs）的存在是否与皮肤黑色素瘤的特定阶段相关，这可能有助于揭示它们的预后意义以及III A期矛盾的生存结果。本研究分析了2021年至2023年间皮肤黑色素瘤前哨淋巴结活检的病例。纳入了确诊为CM的患者、可用的组织学切片以及有关肿瘤分期的临床信息。对原发肿瘤分期与孤立肿瘤细胞的存在之间的相关性进行了统计分析。本研究分析了462例前哨淋巴结活检，结果显示77.1%为阴性病例，22.9%为阳性病例。在24例（5.2%）中观察到孤立肿瘤细胞，最常见于早期阶段（如pT1b和pT2a）。统计分析证实ITCs的存在与早期肿瘤之间存在显著相关性（ = 0.014）。尽管ITCs会导致分期上调，但其预后影响似乎有限，尤其是在薄型黑色素瘤中，其生存率与IB期的相关性比与III A期的相关性更高。这与乳腺癌研究的结果一致，在乳腺癌研究中，由于ITCs对预后的影响极小，在分期时不将其等同于转移。目前的黑色素瘤分期实践可能会受益于将ITCs与较大的转移灶区分开来，以更好地反映实际的转移负担并指导治疗决策。
