D2-40 lymphatic marker for detecting lymphatic invasion in thin to intermediate thickness melanomas: Association with sentinel lymph node status and prognostic value - A retrospective case study

Laurel E. Fohn, Adrian Rodriguez, Mark C. Kelley, Fei Ye, Yu Shyr, George Stricklin, Jason B. Robbins

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Abstract

Background: Sentinel lymph node (SLN) status is the greatest prognostic factor of morbidity in melanoma. D2-40 antibody specifically marks lymphatic endothelium and has been used for identifying lymphatic invasion (LI) in multiple cancers. Objective: We sought to determine the relationship between melanoma lymphatic invasion (as detected using D2-40 on primary melanoma biopsies/excisions) and the presence or absence of melanoma in subsequent SLN biopsy. Methods: We retrospectively evaluated LI using D2-40 on primary biopsies/excisions from patients with thin to intermediate thickness (Breslow thickness: ≤2.0 mm) melanomas, who underwent lymphatic mapping and SLN biopsy, and whose SLN status was known. Sixty-four cases met the criteria and were available for analysis. We analyzed patient age, patient sex, mitotic rate, ulceration, tumor depth, and D2-40 detected LI as predictors of SLN status. Results: Lymphatic invasion detection increased from 3.1% using hematoxylin and eosin only to 21.9% using D2-40. Twelve of 14 patients with D2-40 LI were SLN positive (positive predictive value, 85.7%). D2-40 LI was detected in the primary biopsy specimen of 12 of 18 patients with a positive SLN (sensitivity 66.7%). Of 50 patients without D2-40 LI, 44 were SLN negative (negative predictive value, 88.0%). Of 46 SLN-negative patients, 44 did not have D2-40 LI (specificity, 95.7%). Limitations: Results are retrospective and limited to SLN biopsy performed at one institution. Conclusions: On univariate and multivariate analysis, D2-40-detected LI was the most significant predictor of SLN status. D2-40 antibody staining to detect lymphatic invasion should be incorporated in routine melanoma biopsy evaluation.

Original languageEnglish
Pages (from-to)336-345
Number of pages10
JournalJournal of the American Academy of Dermatology
Volume64
Issue number2
DOIs
Publication statusPublished - 2011 Feb 1

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Melanoma
Retrospective Studies
Sentinel Lymph Node Biopsy
Biopsy
Lymphatic Endothelium
Sentinel Lymph Node
Antibodies
Hematoxylin
Eosine Yellowish-(YS)
Neoplasms
Multivariate Analysis
Staining and Labeling
Morbidity

All Science Journal Classification (ASJC) codes

  • Dermatology

Cite this

@article{a717ed646d824ed2a75a9bdc2097e7d4,
title = "D2-40 lymphatic marker for detecting lymphatic invasion in thin to intermediate thickness melanomas: Association with sentinel lymph node status and prognostic value - A retrospective case study",
abstract = "Background: Sentinel lymph node (SLN) status is the greatest prognostic factor of morbidity in melanoma. D2-40 antibody specifically marks lymphatic endothelium and has been used for identifying lymphatic invasion (LI) in multiple cancers. Objective: We sought to determine the relationship between melanoma lymphatic invasion (as detected using D2-40 on primary melanoma biopsies/excisions) and the presence or absence of melanoma in subsequent SLN biopsy. Methods: We retrospectively evaluated LI using D2-40 on primary biopsies/excisions from patients with thin to intermediate thickness (Breslow thickness: ≤2.0 mm) melanomas, who underwent lymphatic mapping and SLN biopsy, and whose SLN status was known. Sixty-four cases met the criteria and were available for analysis. We analyzed patient age, patient sex, mitotic rate, ulceration, tumor depth, and D2-40 detected LI as predictors of SLN status. Results: Lymphatic invasion detection increased from 3.1{\%} using hematoxylin and eosin only to 21.9{\%} using D2-40. Twelve of 14 patients with D2-40 LI were SLN positive (positive predictive value, 85.7{\%}). D2-40 LI was detected in the primary biopsy specimen of 12 of 18 patients with a positive SLN (sensitivity 66.7{\%}). Of 50 patients without D2-40 LI, 44 were SLN negative (negative predictive value, 88.0{\%}). Of 46 SLN-negative patients, 44 did not have D2-40 LI (specificity, 95.7{\%}). Limitations: Results are retrospective and limited to SLN biopsy performed at one institution. Conclusions: On univariate and multivariate analysis, D2-40-detected LI was the most significant predictor of SLN status. D2-40 antibody staining to detect lymphatic invasion should be incorporated in routine melanoma biopsy evaluation.",
author = "Fohn, {Laurel E.} and Adrian Rodriguez and Kelley, {Mark C.} and Fei Ye and Yu Shyr and George Stricklin and Robbins, {Jason B.}",
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D2-40 lymphatic marker for detecting lymphatic invasion in thin to intermediate thickness melanomas : Association with sentinel lymph node status and prognostic value - A retrospective case study. / Fohn, Laurel E.; Rodriguez, Adrian; Kelley, Mark C.; Ye, Fei; Shyr, Yu; Stricklin, George; Robbins, Jason B.

In: Journal of the American Academy of Dermatology, Vol. 64, No. 2, 01.02.2011, p. 336-345.

Research output: Contribution to journalArticle

TY - JOUR

T1 - D2-40 lymphatic marker for detecting lymphatic invasion in thin to intermediate thickness melanomas

T2 - Association with sentinel lymph node status and prognostic value - A retrospective case study

AU - Fohn, Laurel E.

AU - Rodriguez, Adrian

AU - Kelley, Mark C.

AU - Ye, Fei

AU - Shyr, Yu

AU - Stricklin, George

AU - Robbins, Jason B.

PY - 2011/2/1

Y1 - 2011/2/1

N2 - Background: Sentinel lymph node (SLN) status is the greatest prognostic factor of morbidity in melanoma. D2-40 antibody specifically marks lymphatic endothelium and has been used for identifying lymphatic invasion (LI) in multiple cancers. Objective: We sought to determine the relationship between melanoma lymphatic invasion (as detected using D2-40 on primary melanoma biopsies/excisions) and the presence or absence of melanoma in subsequent SLN biopsy. Methods: We retrospectively evaluated LI using D2-40 on primary biopsies/excisions from patients with thin to intermediate thickness (Breslow thickness: ≤2.0 mm) melanomas, who underwent lymphatic mapping and SLN biopsy, and whose SLN status was known. Sixty-four cases met the criteria and were available for analysis. We analyzed patient age, patient sex, mitotic rate, ulceration, tumor depth, and D2-40 detected LI as predictors of SLN status. Results: Lymphatic invasion detection increased from 3.1% using hematoxylin and eosin only to 21.9% using D2-40. Twelve of 14 patients with D2-40 LI were SLN positive (positive predictive value, 85.7%). D2-40 LI was detected in the primary biopsy specimen of 12 of 18 patients with a positive SLN (sensitivity 66.7%). Of 50 patients without D2-40 LI, 44 were SLN negative (negative predictive value, 88.0%). Of 46 SLN-negative patients, 44 did not have D2-40 LI (specificity, 95.7%). Limitations: Results are retrospective and limited to SLN biopsy performed at one institution. Conclusions: On univariate and multivariate analysis, D2-40-detected LI was the most significant predictor of SLN status. D2-40 antibody staining to detect lymphatic invasion should be incorporated in routine melanoma biopsy evaluation.

AB - Background: Sentinel lymph node (SLN) status is the greatest prognostic factor of morbidity in melanoma. D2-40 antibody specifically marks lymphatic endothelium and has been used for identifying lymphatic invasion (LI) in multiple cancers. Objective: We sought to determine the relationship between melanoma lymphatic invasion (as detected using D2-40 on primary melanoma biopsies/excisions) and the presence or absence of melanoma in subsequent SLN biopsy. Methods: We retrospectively evaluated LI using D2-40 on primary biopsies/excisions from patients with thin to intermediate thickness (Breslow thickness: ≤2.0 mm) melanomas, who underwent lymphatic mapping and SLN biopsy, and whose SLN status was known. Sixty-four cases met the criteria and were available for analysis. We analyzed patient age, patient sex, mitotic rate, ulceration, tumor depth, and D2-40 detected LI as predictors of SLN status. Results: Lymphatic invasion detection increased from 3.1% using hematoxylin and eosin only to 21.9% using D2-40. Twelve of 14 patients with D2-40 LI were SLN positive (positive predictive value, 85.7%). D2-40 LI was detected in the primary biopsy specimen of 12 of 18 patients with a positive SLN (sensitivity 66.7%). Of 50 patients without D2-40 LI, 44 were SLN negative (negative predictive value, 88.0%). Of 46 SLN-negative patients, 44 did not have D2-40 LI (specificity, 95.7%). Limitations: Results are retrospective and limited to SLN biopsy performed at one institution. Conclusions: On univariate and multivariate analysis, D2-40-detected LI was the most significant predictor of SLN status. D2-40 antibody staining to detect lymphatic invasion should be incorporated in routine melanoma biopsy evaluation.

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