Weissmann A, Roses D F, Harris M N, Dubin N
Am J Dermatopathol. 1984 Summer;6 Suppl:35-41.
Elective regional lymph-node dissection was performed on 98 patients with clinical Stage I cutaneous malignant melanoma and 26 of them were found to have microscopic evidence of metastases. The histology of the primary lesions was reviewed in order to find possible prognostic parameters that would allow prediction of nodal involvement. There was an increased risk of occult lymph node metastases with increasing thickness of the primary lesions. While this trend was not found to be statistically significant, no occult lymph node metastases were found for lesions less than 1.0 mm in thickness. Significant features included mitotic figures, "prognostic index," and plasma cells within the infiltrate. A multiple logistic regression analysis identified three groups of patients with low, medium, and high risk of occult metastases, based on thickness, location, and plasma cells. The correlation between plasma cells and the incidence of metastases in lymph nodes might represent an immunologic phenomenon.
对98例临床I期皮肤恶性黑色素瘤患者进行了选择性区域淋巴结清扫术，其中26例发现有微小转移证据。对原发灶的组织学进行了复查，以寻找可能的预后参数，从而能够预测淋巴结受累情况。随着原发灶厚度增加，隐匿性淋巴结转移风险升高。虽然这一趋势未发现具有统计学意义，但厚度小于1.0 mm的病灶未发现隐匿性淋巴结转移。显著特征包括核分裂象、“预后指数”以及浸润灶内的浆细胞。多因素逻辑回归分析根据厚度、部位和浆细胞确定了三组隐匿性转移低、中、高风险患者。浆细胞与淋巴结转移发生率之间的相关性可能代表一种免疫现象。
