Detection of tyrosinase mRNA in the sentinel lymph nodes of melanoma patients is not a predictor of short-term disease recurrence

Sentinel lymph node evaluation has enabled identification of patients with cutaneous melanoma who might benefit from elective regional lymph node dissection. Sentinel nodes are currently assessed by histologic and reverse transcription polymerase chain reaction (RT–PCR) evaluation for melanocyte-spe...

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Bibliographic Details
Published in:Modern pathology 2007-04, Vol.20 (4), p.427-434
Main Authors: Tatlidil, Cuneyt, Parkhill, Winston S, Giacomantonio, Carman A, Greer, Wenda L, Morris, Steven F, Walsh, Noreen M G
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biomarkers, Tumor
Biopsy
Dissection
Female
Follow-Up Studies
Health sciences
Humans
Laboratories
Laboratory Medicine
Lymph Node Excision
Lymph Nodes - enzymology
Lymph Nodes - surgery
Lymphatic Metastasis
Lymphatic system
Male
Medical prognosis
Medicine
Medicine & Public Health
Melanoma
Melanoma - chemistry
Melanoma - secondary
Metastasis
Middle Aged
Monophenol Monooxygenase - genetics
Monophenol Monooxygenase - metabolism
Neoplasm Recurrence, Local
Neoplasm Staging
original-article
Pathology
Patients
Polymerase chain reaction
Reverse Transcriptase Polymerase Chain Reaction
RNA, Messenger - analysis
Sentinel Lymph Node Biopsy
Skin cancer
Skin Neoplasms - chemistry
Skin Neoplasms - pathology
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Summary:Sentinel lymph node evaluation has enabled identification of patients with cutaneous melanoma who might benefit from elective regional lymph node dissection. Sentinel nodes are currently assessed by histologic and reverse transcription polymerase chain reaction (RT–PCR) evaluation for melanocyte-specific markers. The clinical significance of positive findings by RT–PCR in the absence of histologic evidence of metastasis (HISNEG/PCRPOS) remains unclear. Examination of 264 lymph nodes from 139 patients revealed histopathologic positivity in 34 patients (24.5%), in which 26 also demonstrated simultaneous RT–PCR positivity (HISPOS/PCRPOS). Of 35 HISNEG/PCRPOS patients (25.2%), five also had nodal capsular nevi. In total, capsular nevi were detected in 13 patients (9.4%). A total of 70 patients (50.4%) had negative sentinel nodes by both histopathology and RT–PCR (HISNEG/PCRNEG). Over a median follow-up of 25 months, local and/or systemic recurrence developed in 31 patients (22.3%). Recurrence rates were similar among patients with histopathologic evidence of sentinel lymph node metastasis, irrespective of RT–PCR status (HISPOS/PCRPOS 62%; HISPOS/PCRNEG 75%). In contrast, only 10% of HISNEG/PCRNEG patients developed recurrence, significantly less than those in either HISPOS group (P
ISSN:0893-3952
1530-0285
DOI:10.1038/modpathol.3800754