Interval sentinel lymph nodes in melanoma: a digital pathology analysis of Ki67 expression and microvascular density

Christian Marinaccio, Giuseppe Giudice, Eleonora Nacchiero, Fabio Robusto, Giuseppina Opinto, Gaetano Lastilla, Eugenio Maiorano, Domenico Ribatti

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The presence of interval sentinel lymph nodes in melanoma is documented in several studies, but controversies still exist about the management of these lymph nodes. In this study, an immunohistochemical evaluation of tumor cell proliferation and neo-angiogenesis has been performed with the aim of establishing a correlation between these two parameters between positive and negative interval sentinel lymph nodes. This retrospective study reviewed data of 23 patients diagnosed with melanoma. Bioptic specimens of interval sentinel lymph node were retrieved, and immunohistochemical reactions on tissue sections were performed using Ki67 as a marker of proliferation and CD31 as a blood vessel marker for the study of angiogenesis. The entire stained tissue sections for each case were digitized using Aperio Scanscope Cs whole-slide scanning platform and stored as high-resolution images. Image analysis was carried out on three selected fields of equal area using IHC Nuclear and Microvessel analysis algorithms to determine positive Ki67 nuclei and vessel number. Patients were divided into positive and negative interval sentinel lymph node groups, and the positive interval sentinel lymph node group was further divided into interval positive with micrometastasis and interval positive with macrometastasis subgroups. The analysis revealed a significant difference between positive and negative interval sentinel lymph nodes in the percentage of Ki67-positive nuclei and mean vessel number suggestive of an increased cellular proliferation and angiogenesis in positive interval sentinel lymph nodes. Further analysis in the interval positive lymph node group showed a significant difference between micro- and macrometastasis subgroups in the percentage of Ki67-positive nuclei and mean vessel number. Percentage of Ki67-positive nuclei was increased in the macrometastasis subgroup, while mean vessel number was increased in the micrometastasis subgroup. The results of this study suggest that the correlation between tumor cell proliferation and neo-angiogenesis in interval sentinel lymph nodes in melanoma could be used as a good predictive marker to distinguish interval positive sentinel lymph nodes with micrometastasis from interval positive lymph nodes with macrometastasis subgroups.

Original languageEnglish
JournalClinical and Experimental Medicine
DOIs
Publication statusAccepted/In press - Aug 15 2015

Fingerprint

Pathology
Melanoma
Neoplasm Micrometastasis
Lymph Nodes
Cell Proliferation
Cell proliferation
Tumors
Tissue
Sentinel Lymph Node
cyhalothrin
Blood vessels
Image resolution
Microvessels
Image analysis
Blood Vessels
Neoplasms
Retrospective Studies
Scanning

Keywords

  • Angiogenesis
  • Interval lymph node
  • Melanoma
  • Metastasis
  • Tumor progression

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Interval sentinel lymph nodes in melanoma : a digital pathology analysis of Ki67 expression and microvascular density. / Marinaccio, Christian; Giudice, Giuseppe; Nacchiero, Eleonora; Robusto, Fabio; Opinto, Giuseppina; Lastilla, Gaetano; Maiorano, Eugenio; Ribatti, Domenico.

In: Clinical and Experimental Medicine, 15.08.2015.

Research output: Contribution to journalArticle

Marinaccio, Christian ; Giudice, Giuseppe ; Nacchiero, Eleonora ; Robusto, Fabio ; Opinto, Giuseppina ; Lastilla, Gaetano ; Maiorano, Eugenio ; Ribatti, Domenico. / Interval sentinel lymph nodes in melanoma : a digital pathology analysis of Ki67 expression and microvascular density. In: Clinical and Experimental Medicine. 2015.
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