TY - JOUR
T1 - Prognostic implication of lymphovascular invasion detected by double immunostaining for D2-40 and MITF1 in primary cutaneous melanoma
AU - Feldmeyer, Laurence
AU - Tetzlaff, Michael
AU - Fox, Patricia
AU - Nagarajan, Priyadharsini
AU - Curry, Jonathan
AU - Ivan, Doina
AU - Cabala, Carlos A.Torres
AU - Prieto, Victor G.
AU - Aung, Phyu P.
N1 - Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Background: Lymphovascular invasion (LVI) is associated with adverse outcomes in primary cutaneous melanoma (PCM). Detection of LVI by hematoxylin and eosin staining alone is 0%-6%, but targeting lymphovascular structures increases the detection rate. Objective: To examine the prognostic significance of LVI detected by immunostaining for D2-40 and microphthalmia-associated transcription factor 1 (MITF1) in PCM. Methods: The authors retrospectively analyzed 120 PCM samples. We compared the LVI detection rates of immunostaining for D2-40 only (22%), double staining for D2-40 and MITF1 (38%), and hematoxylin and eosin, and examined the association of LVI with clinicopathologic variables and clinical outcomes. Results: Immunolabeling with both methods significantly increased the LVI detection rate. Double staining for D2-40 and MITF1 as well as D2-40-detected LVI was significantly associated with increased Breslow thickness, number of mitoses, and sentinel lymph node (SLN) metastasis. D2-40-detected LVI was also associated with ulceration. Although the difference was not significant, double staining for D2-40 and MITF1 allowed for easier detection of LVI than D2-40 alone. Limitations: This study was conducted in a tertiary referral institution; therefore, a referral bias cannot be excluded. Conclusions: Immunolabeling increased detection of LVI in PCM. Because LVI is a positive predictive marker for SLN metastasis, the authors propose using anti-D2-40 and anti-MITF1 in the evaluation of LVI in patients with PCM with a certain risk of SLN metastasis.
AB - Background: Lymphovascular invasion (LVI) is associated with adverse outcomes in primary cutaneous melanoma (PCM). Detection of LVI by hematoxylin and eosin staining alone is 0%-6%, but targeting lymphovascular structures increases the detection rate. Objective: To examine the prognostic significance of LVI detected by immunostaining for D2-40 and microphthalmia-associated transcription factor 1 (MITF1) in PCM. Methods: The authors retrospectively analyzed 120 PCM samples. We compared the LVI detection rates of immunostaining for D2-40 only (22%), double staining for D2-40 and MITF1 (38%), and hematoxylin and eosin, and examined the association of LVI with clinicopathologic variables and clinical outcomes. Results: Immunolabeling with both methods significantly increased the LVI detection rate. Double staining for D2-40 and MITF1 as well as D2-40-detected LVI was significantly associated with increased Breslow thickness, number of mitoses, and sentinel lymph node (SLN) metastasis. D2-40-detected LVI was also associated with ulceration. Although the difference was not significant, double staining for D2-40 and MITF1 allowed for easier detection of LVI than D2-40 alone. Limitations: This study was conducted in a tertiary referral institution; therefore, a referral bias cannot be excluded. Conclusions: Immunolabeling increased detection of LVI in PCM. Because LVI is a positive predictive marker for SLN metastasis, the authors propose using anti-D2-40 and anti-MITF1 in the evaluation of LVI in patients with PCM with a certain risk of SLN metastasis.
KW - D2-40
KW - Immunohistochemistry
KW - Lymphovascular invasion
KW - MITF1
KW - Metastasis
KW - Primary cutaneous melanoma
KW - Sentinel lymph node
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U2 - 10.1097/DAD.0000000000000453
DO - 10.1097/DAD.0000000000000453
M3 - Article
C2 - 26675354
AN - SCOPUS:84950160821
SN - 0193-1091
VL - 38
SP - 484
EP - 491
JO - American Journal of Dermatopathology
JF - American Journal of Dermatopathology
IS - 7
ER -