Mititelu Teodora Sidonia, Mititelu Mihaela Raluca, Bucurica Sandica, Costache Daniel Octavian
Department of Plastic and Reconstructive Surgery, "Bagdasar-Arseni" Clinical Emergency Hospital, 041915 Bucharest, Romania.
Department of Nuclear Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Diagnostics (Basel). 2025 May 8;15(10):1192. doi: 10.3390/diagnostics15101192.
: Malignant melanoma (MM) is an aggressive neoplasm with a rising global incidence. Accurate staging and risk stratification are essential for guiding therapeutic decisions and improving patient prognosis. [18F]-FDG PET-CT enables the non-invasive assessment of tumor metabolic activity, offering a valuable adjunct to histopathological evaluation. However, the correlation between PET-CT findings and established prognostic markers in MM, such as Breslow thickness, ulceration, and mitotic rate, remains insufficiently explored. : This retrospective observational study included 61 patients diagnosed with MM, of whom 48 met the inclusion criteria. Quantitative and qualitative variables such as SULmax, Breslow thickness, Ki-67 expression, and mitotic rate were analyzed using descriptive statistics, while correlations between PET-CT findings, SLNB, and histopathological characteristics were assessed using Spearman's correlation test. A -value < 0.05 was considered statistically significant. : Significant associations were identified between ulceration and both overall metastases ( = 0.01) and pulmonary metastases ( = 0.02). Breslow thickness showed a positive correlation with metastatic spread ( = 0.01), reinforcing its role as a key prognostic indicator. Perineural and vascular invasion were significantly associated with intra-abdominal metastases ( < 0.001 and = 0.0007, respectively). Tumor-infiltrating lymphocytes (TILs) were inversely correlated with intra-abdominal metastases ( = 0.05), while sentinel lymph node positivity correlated with the presence of regional ( = 0.008) and distant ( = 0.02) metastases. Additionally, subcutaneous SULmax values were significantly higher in male patients compared to females ( = 0.04). : Integrating PET-CT metabolic parameters with histopathological markers enhances the assessment of MM aggressiveness and metastatic potential. By refining risk stratification, PET-CT may contribute to personalized therapeutic strategies and improved patient management in MM.
恶性黑色素瘤（MM）是一种侵袭性肿瘤，全球发病率呈上升趋势。准确分期和风险分层对于指导治疗决策和改善患者预后至关重要。[18F]-FDG PET-CT能够对肿瘤代谢活性进行非侵入性评估，为组织病理学评估提供有价值的辅助手段。然而，PET-CT检查结果与MM中已确立的预后标志物（如Breslow厚度、溃疡形成和有丝分裂率）之间的相关性仍未得到充分研究。
这项回顾性观察性研究纳入了61例诊断为MM的患者，其中48例符合纳入标准。使用描述性统计分析SULmax、Breslow厚度、Ki-67表达和有丝分裂率等定量和定性变量，同时使用Spearman相关检验评估PET-CT检查结果、前哨淋巴结活检（SLNB）和组织病理学特征之间的相关性。P值<0.05被认为具有统计学意义。
溃疡形成与全身转移（P = 0.01）和肺转移（P = 0.02）均存在显著相关性。Breslow厚度与转移扩散呈正相关（P = 0.01），强化了其作为关键预后指标的作用。神经周围和血管侵犯分别与腹腔内转移显著相关（P < 0.001和P = 0.0007）。肿瘤浸润淋巴细胞（TILs）与腹腔内转移呈负相关（P = 0.05），而前哨淋巴结阳性与区域转移（P = 0.008）和远处转移（P = 0.02）的存在相关。此外，男性患者皮下SULmax值显著高于女性（P = 0.04）。
将PET-CT代谢参数与组织病理学标志物相结合可增强对MM侵袭性和转移潜能的评估。通过优化风险分层，PET-CT可能有助于MM的个性化治疗策略制定和改善患者管理。
