Immunohistochemical detection of lymphovascular invasion with D2-40 in melanoma correlates with sentinel lymph node status, metastasis and survival

• Published in: Journal of cutaneous pathology Vol. 36; no. 11; pp. 1157 - 1163
• Main Authors: Petersson, Fredrik, Diwan, A. Hafeez, Ivan, Doina, Gershenwald, Jeffrey E., Johnson, Marcella M., Harrell, Robyn, Prieto, Victor G.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.11.2009; Wiley-Blackwell
• Subjects: Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Biological and medical sciences; Dermatology; Hematologic and hematopoietic diseases; Humans; Immunohistochemistry; Kaplan-Meier Estimate; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphatic Metastasis - pathology; Medical sciences; Medicin och hälsovetenskap; Melanoma - metabolism; Melanoma - mortality; Melanoma - pathology; Sentinel Lymph Node Biopsy; Skin Neoplasms - metabolism; Skin Neoplasms - mortality; Skin Neoplasms - pathology; Tumors of the skin and soft tissue. Premalignant lesions; Immunohistochemistry; Anatomic pathology; Prognosis; Dermatology; Sentinel lymph node metastasis; Malignant melanoma; Malignant lymphadenopathy; Malignant hemopathy; Malignant tumor; Survival; Cancer
• ISSN: 0303-6987; 1600-0560; 1600-0560
• DOI: 10.1111/j.1600-0560.2008.01242.x

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.