Hieken T J, Ronan S G, Farolan M, Shilkaitis A L, Kim D K, Das Gupta T K
Department of Surgical Oncology, University of Illinois at Chicago 60612-7322, USA.
Surgery. 1995 Oct;118(4):669-73; discussion 673-5. doi: 10.1016/s0039-6060(05)80034-0.
Elective lymph node dissection for malignant melanoma is still controversial. Experimental studies suggest that differential expression, activation, or both of beta1 integrins facilitate melanoma metastases. However, the clinical significance of beta1 integrin expression in human melanoma is unclear.
We examined primary cutaneous melanomas from 76 patients undergoing elective lymph mode dissection. We quantified the percentage of tumor area stained by beta1 integrin antibody with an image analyzer.
beta1 integrin was expressed in all 23 primary tumors from patients with pathologically positive lymph nodes (LNs) but in only 14 (26%) of 53 cases with pathologically negative nodes (p < 0.001). No patients with beta1 integrin-negative tumors had LN involvement, whereas 23 (62%) of 37 patients with beta1 integrin-positive tumors had LN metastases (p < 0.001). Furthermore, 21 (91%) of 23 cases with LN metastases but only 4 (8%) of 53 cases without had beta1 integrin staining of 10% or more of tumor area (p < 0.001).
Our study is the first to show a correlation between expression of a molecular marker in the primary cutaneous melanoma and likelihood of regional LN metastases. beta1 immunostaining of 10% or more of tumor area reliably predicts patients most likely to harbor occult LN metastases and likely to benefit from ELND.
恶性黑色素瘤的选择性淋巴结清扫术仍存在争议。实验研究表明，β1整合素的差异表达、激活或两者兼而有之促进黑色素瘤转移。然而，β1整合素在人类黑色素瘤中表达的临床意义尚不清楚。
我们检查了76例行选择性淋巴结清扫术患者的原发性皮肤黑色素瘤。我们用图像分析仪量化β1整合素抗体染色的肿瘤面积百分比。
在病理检查淋巴结阳性（LN）患者的所有23例原发性肿瘤中均检测到β1整合素表达，但在病理检查淋巴结阴性的53例患者中仅14例（26%）检测到（p<0.001）。β1整合素阴性肿瘤患者均无LN受累，而37例β1整合素阳性肿瘤患者中有23例（62%）发生LN转移（p<0.001）。此外，23例发生LN转移的患者中有21例（91%），但53例未发生转移的患者中只有4例（8%）肿瘤面积的β1整合素染色达到10%或更多（p<0.001）。
我们的研究首次表明原发性皮肤黑色素瘤中分子标志物的表达与区域LN转移可能性之间存在相关性。肿瘤面积10%或更多的β1免疫染色可可靠地预测最有可能隐匿性LN转移且可能从ELND中获益的患者。
