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Immunohistochemical detection of lymphovascular invasion with D2‐40 in melanoma correlates with sentinel lymph node status, metastasis and survival
Author(s) -
Petersson Fredrik,
Diwan A. Hafeez,
Ivan Doina,
Gershenwald Jeffrey E.,
Johnson Marcella M.,
Harrell Robyn,
Prieto Victor G.
Publication year - 2009
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.1600-0560.2008.01242.x
Subject(s) - lymphovascular invasion , medicine , immunohistochemistry , sentinel lymph node , proportional hazards model , hazard ratio , metastasis , pathology , univariate analysis , biopsy , oncology , cancer , multivariate analysis , breast cancer , confidence interval
Using immunohistochemistry with anti‐D2‐40 for the detection of lymphovascular invasion (LVI‐IHC) in 74 cases of invasive melanoma, we found LVI in 23% (16/74) of the tumors. Data on sentinel lymph node (SLN) biopsy were available for 36 patients. Sixty‐seven percent (6/9) of patients with LVI‐IHC and 19% (5/27) without LVI‐IHC had positive SLN. Follow‐up data were available for 60 patients. Data on recurrence/metastasis were available for 60 patients. Twenty‐five percent (15/60) had LVI with immunohistochemistry. Fifty‐three percent (8/15) of these patients had “distant” metastasis or regional recurrence compared with 11% (5/45) in those without LVI‐IHC. Overall and disease‐specific survival was shorter for patients with LVI. In both the univariate and multivariate Cox proportional hazards regression models, LVI‐IHC in addition to ulceration was statistically significant with respect to overall survival. Specifically, in the reduced multivariate model, compared with patients with no LVI, patients with intratumoral LVI had a hazard ratio (HR) of 5.4 (95% CI 1.6–18.4), while patients with peritumoral LVI had a HR of 3.8 (95% CI 0.7–20.9). In addition, patients with ulceration had an increased hazard of 4.4 (95% CI 1.2–16.8). For the first time, we herein show a positive correlation with LVI in melanoma detected with immunohistochemistry and distant metastasis, overall survival and disease‐free survival.