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J Cutan Pathol. 2018 Jun;45(6):377-386. doi: 10.1111/cup.13127. Epub 2018 Mar 23.

Histological immune response patterns in sentinel lymph nodes involved by metastatic melanoma and prognostic significance.

Author information

1
Department of Medicine, Pennsylvania Hospital, Philadelphia, Pennsylvania.
2
Department of Biostatistic and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania.
3
Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
4
Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
5
Department of Breast Oncology, Moffitt Cancer Center, Tampa, Florida.
6
Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania.

Abstract

BACKGROUND:

To further characterize the micromorphometric immunological pattern to metastatic melanoma in sentinel lymph node (SLN) biopsies and completion lymph node (CLN) dissections and their relation to 5-year overall survival (OS).

METHODS:

Retrospective cohort of 49 patients from 1996 to 2005 with a positive SLN who underwent CLN dissection (CLD) was studied. Micromorphometric characteristics included follicular center count (FCC)/profile, sinus histiocytosis, metastatic size, tumor infiltrating lymphocytes (intranodal), paracortical dendritic cells, germinal center reaction and morphology. Comparison of Kaplan-Meier survival curves used the exact log-rank statistic.

RESULTS:

In the high-FCC (n = 5-51) vs the low-FCC (n < 5) lymph nodes, a delayed separation occurred at 3 years, with 5-year OS rates being 73% vs 54% in the high- and low-FCC groups, respectively. Improved survival up to 3 years was also noted in CLDs that showed a higher FCC when compared to the prior SLN. Patients with metastatic deposits >2 mm had significantly lower 5-year survival (both <.001).

CONCLUSIONS:

Nodal micromorphometric features (ie, FCC) are probably related to host immune response to metastasis. Quantitative evaluation of lymphoid follicular centers could provide valuable prognostic information to help to stratify patients.

KEYWORDS:

B-lymphocyte; T-lymphocyte; histology; immunology; melanoma; metastatic melanoma; prognosis; sentinel lymph node

PMID:
29446846
DOI:
10.1111/cup.13127
[Indexed for MEDLINE]

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