HMB-45 immunohistochemical staining of sentinel lymph nodes - A specific method for enhancing detection of micrometastases in patients with melanoma

Citation
Bl. Baisden et al., HMB-45 immunohistochemical staining of sentinel lymph nodes - A specific method for enhancing detection of micrometastases in patients with melanoma, AM J SURG P, 24(8), 2000, pp. 1140-1146
Citations number
31
Categorie Soggetti
Research/Laboratory Medicine & Medical Tecnology","Medical Research Diagnosis & Treatment
Journal title
AMERICAN JOURNAL OF SURGICAL PATHOLOGY
ISSN journal
01475185 → ACNP
Volume
24
Issue
8
Year of publication
2000
Pages
1140 - 1146
Database
ISI
SICI code
0147-5185(200008)24:8<1140:HISOSL>2.0.ZU;2-F
Abstract
Despite the profound therapeutic and prognostic implications of nodal metas tases in patients with melanoma. there is no consensus strategy for the opt imal detection of metastases in sentinel lymph node biopsies. Traditional m icroscopic examination may be too crude to detect scattered, individual tum or cells. Conversely, molecular genetic techniques are prone to false-posit ive results. The authors evaluated the ability of HMB-45 immunohistochemist ry to enhance detection of melanoma cells in histologically negative sentin el lymph nodes. Ninety-six sentinel lymph nodes, collected over a 25-month period from 66 consecutive patients with melanoma, were processed routinely and sectioned serially. Slides 1, 3, and 5 were stained with hematoxylin a nd eosin. HMB-45 staining was performed on an intervening slide in histolog ically negative nodes. To assess the background incidence of HMB-45-positiv e cells in lymph nodes draining the skin, the authors stained 244 cervical and axillary lymph nodes from patients without melanoma. Metastases were ap parent microscopically in 12 (18%) of the 66 patients with melanoma. Of the remaining 54 patients, four patients (7%) had lymph nodes harboring indivi dual, scattered HMB-45-positive cells. Benign nevocellular aggregates were present in four of the 96 sentinel lymph nodes (4% nodal incidence), but th ey were HMB-45-negative. The authors did not observe a single HMB-45-positi ve cell in the 244 lymph nodes from patients without melanoma. Immunohistoc hemistry appears to represent a specific means of enhancing tumor detection in sentinel lymph nodes from patients with melanoma.