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
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.