Sentinel node in melanoma patients: triple negativity with routine techniques and PCR as positive prognostic factor for survival

Abstract

Lymph node mapping and sentinel lymph node biopsy are currently used to stage patients with cutaneous malignant melanoma. Immunohistochemical stains contribute to the detection of micrometastases; however, molecular biology techniques are associated with better diagnostic sensitivity. Sixty sentinel lymph nodes were included in this study. The primary lesions were malignant melanoma stage I or II, with a follow-up of longer than 2 years. Sentinel lymph nodes were studied with hematoxylin-eosin, immunohistochemistry for S-100 and HMB-45, and molecular biology techniques (reverse transcription (RT)-PCR) for the detection of tyrosinase messenger RNA. In 15 of 60 cases (25%), tyrosinase was detected by RT-PCR; three of these cases were also positive by immunohistochemistry. The population was divided into three groups: (i) hematoxylin-eosinÀ/ immunohistochemistry þ /molecular biology techniques þ (3 cases); (ii) hematoxylin-eosinÀ/immunohistochemistryÀ/molecular biology techniques þ (12 cases); (iii) hematoxylin-eosinÀ/immunohistochemistryÀ/ molecular biology techniquesÀ (45 cases). Correlation of the groups with overall survival showed the following: (i) 2 of 3 patients died (67%); (ii) 5 of 12 died (42%), and (iii) all 45 patients are alive, with no lymphadenectomy and a median follow-up of 84 months. The inclusion of molecular biology techniques appears to be of great value for the detection of sentinel lymph node micrometastases in patients with cutaneous malignant melanoma. In our series, those patients who showed negativity with all the three methods had a null recurrence rate. Therefore, this triple negativity could be a positive prognostic factor for overall survival. Our findings suggest the possibility of molecular oncological staging, which would allow the selection of patients with submicroscopic metastases for a complete treatment.

Estimating the whole bone-marrow asset in humans by a computational approach to integrated PET/CT imaging

“…Indeed, only patients treated for a nonulcerated lesion with a Breslow thickness less than 1 mm, and thus a 10-year overall survival approaching 100 %, were enrolled [35]. Limiting the subjects to those with a negative sentinel node biopsy would have further decreased the likelihood of residual tumour presence [36]. Finally, the minimal prevalence of patients with residual disease was further reduced by the 2-year waiting time required for enrolment as well as by the absence of any evidence of relapse at the time of the scan used for analysis.…”

Current concepts of metastasis in melanoma

“…Several studies indicate that approximately 10% of sentinel lymph node-negative (as determined by hematoxylin and eosin and immunohistochemical staining) patients may experience local or widespread metastases [11]. A recent article presents results of combined studies of sentinel lymph nodes by three techniques: staining with hematoxylin and eosin, staining with antibodies against S-100 and HMB-45, and detection of tyrosinase mRNA by RT-PCR [12]. In this study, the 45 patients who were negative for melanoma by all three techniques did not have a recurrence in over 2 years of follow-up.…”

Engineering bacterial outer membrane vesicles as transdermal nanoplatforms for photo-TRAIL–programmed therapy against melanoma

“…S100-β is an antibody that is most frequently used in clinical setting to confirm the cytologic diagnosis of melanoma. Loss of S100-β expression is common in metastatic lesions and remains the most sensitive marker for tumors of melanocytic origin ( 46 ). S100-β expression could not be observed in tumors of ICG+NIR and I-TRAIL+NIR groups ( Fig.…”