Prognostic significance of detecting micrometastases by tyrosinase RT/PCR in sentinel lymph node biopsies: lessons from 322 consecutive melanoma patients

This prospective study was performed to determine the prognostic value of tyrosinase mRNA detection in sentinel lymph nodes (SLN) of melanoma patients. About 847 SLNs from 322 consecutive patients were assessed by histopathology and immunohistochemistry as well as tyrosinase-reverse transcriptase-po...

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Bibliographic Details
Published in:European journal of cancer (1990) 2004-12, Vol.40 (18), p.2812-2819
Main Authors: Ulrich, J., Bonnekoh, B., Böckelmann, R., Schön, M., Schön, M.P., Steinke, R., Roessner, A., Schmidt, U., Gollnick, H.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cohort Studies
Disease-Free Survival
Female
Humans
Lymphatic Metastasis - pathology
Male
Malignant melanoma
Medical sciences
Melanoma - pathology
Microstaging
Middle Aged
Monophenol Monooxygenase - metabolism
Pharmacology. Drug treatments
Prognosis
Prospective Studies
Reverse Transcriptase Polymerase Chain Reaction - methods
Sentinel Lymph Node Biopsy
Sentinel lymph node dissection
Skin Neoplasms - pathology
Tumors
Tyrosinase reverse transcriptase/polymerase chain reaction
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Summary:This prospective study was performed to determine the prognostic value of tyrosinase mRNA detection in sentinel lymph nodes (SLN) of melanoma patients. About 847 SLNs from 322 consecutive patients were assessed by histopathology and immunohistochemistry as well as tyrosinase-reverse transcriptase-polymerase chain reaction (RT/PCR) for the presence of micrometastases. The results were correlated with the prognostic parameters employing a multivariate analysis after a median follow-up of 37 months. Histopathological analysis revealed metastases in 34/322 patients (10.6%). Among the 288 patients with histopathologically negative SLN, tyrosinase-mRNA was detected in 39 patients. A relapse of the tumour occurred in 44.1% of the patients with histopathologically positive SLN, in 25.6% with histopathologically negative, but tyrosinase-RT/PCR-positive SLN, and 8.0% with “double-negative” SLN. A multivariate analysis identified tumour thickness, the histopathological SLN status, and the ulceration of the primary tumour as independent prognostic factors. Thus, by assessing tyrosinase mRNA in the SLN of melanoma patients, we identified a subgroup with histopathologically negative, but Tyr-RT-PCR-positive SLN who have a high risk of disease relapse.
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2004.08.009