Detection of micrometastases in sentinel lymph nodes from melanoma patients: direct comparison of multimarker molecular and immunopathological methods.

Details

Serval ID
serval:BIB_07B3F73AA969
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Detection of micrometastases in sentinel lymph nodes from melanoma patients: direct comparison of multimarker molecular and immunopathological methods.
Journal
Melanoma research
Author(s)
Rimoldi D., Lemoine R., Kurt A.M., Salvi S., Berset M., Matter M., Roche B., Cerottini J.P., Guggisberg D., Krischer J., Braun R., Willi J.P., Antonescu C., Slosman D., Lejeune F.J., Liénard D.
ISSN
0960-8931
Publication state
Published
Issued date
2003
Peer-reviewed
Oui
Volume
13
Number
5
Pages
511-20
Language
english
Notes
Publication types: Comparative Study ; Journal Article - Publication Status: ppublish
Abstract
The technique of sentinel lymph node (SLN) dissection is a reliable predictor of metastatic disease in the lymphatic basin draining the primary melanoma. Reverse transcription-polymerase chain reaction (RT-PCR) is emerging as a highly sensitive technique to detect micrometastases in SLNs, but its specificity has been questioned. A prospective SLN study in melanoma patients was undertaken to compare in detail immunopathological versus molecular detection methods. Sentinel lymphadenectomy was performed on 57 patients, with a total of 71 SLNs analysed. SLNs were cut in slices, which were alternatively subjected to parallel multimarker analysis by microscopy (haematoxylin and eosin and immunohistochemistry for HMB-45, S100, tyrosinase and Melan-A/MART-1) and RT-PCR (for tyrosinase and Melan-A/MART-1). Metastases were detected by both methods in 23% of the SLNs (28% of the patients). The combined use of Melan-A/MART-1 and tyrosinase amplification increased the sensitivity of PCR detection of microscopically proven micrometastases. Of the 55 immunopathologically negative SLNs, 25 were found to be positive on RT-PCR. Notably, eight of these SLNs contained naevi, all of which were positive for tyrosinase and/or Melan-A/MART-1, as detected at both mRNA and protein level. The remaining 41% of the SLNs were negative on both immunohistochemistry and RT-PCR. Analysis of a series of adjacent non-SLNs by RT-PCR confirmed the concept of orderly progression of metastasis. Clinical follow-up showed disease recurrence in 12% of the RT-PCR-positive immunopathology-negative SLNs, indicating that even an extensive immunohistochemical analysis may underestimate the presence of micrometastases. However, molecular analyses, albeit more sensitive, need to be further improved in order to attain acceptable specificity before they can be applied diagnostically.
Keywords
Female, Humans, Immunohistochemistry, Lymphatic Metastasis, Male, Melanoma, Monophenol Monooxygenase, Neoplasm Metastasis, RNA, Reverse Transcriptase Polymerase Chain Reaction, Sentinel Lymph Node Biopsy, Skin Neoplasms, Treatment Outcome, Tumor Markers, Biological
Pubmed
Web of science
Create date
28/01/2008 12:14
Last modification date
20/08/2019 13:30
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