Zusammenfassung
Die Aufarbeitung von Sentinel-Lymphknoten beim malignen Melanom
beinhaltet einen Kompromiss zwischen Effizienz und Arbeitsaufwand, der sich in
unterschiedlichen Vorgehensweisen bzw. Protokollen wiederspiegelt. Die
Herausforderung für den Befunder besteht in der Detektion von
Mikrometastasen und Einzelzellen durch Verwendung mehrerer immunhistochemischer
Antikörper. Die prognostische Bedeutung nodaler Metastasierungsmuster und
minimaler Tumorlast wird zukünftigen multizentrischer Studien mit
Langzeitverläufen überlassen bleiben.
Abstract
The pathological assessment of sentinel lymph nodes for melanoma
contents a compromise between efficacy and expenditure of work, reflecting the
existence of different protocols. The challenge for the pathologist is the
detection of intranodal micrometastases and single cells by using a cocktail of
antibodies. The prognostically impact of nodal metastatic patterns and minimal
tumorload will have to be proved in multicentre trials.
Literatur
-
1
Kretschmer L, Beckmann I, Thoms K M. et al .
Sentinel lymphnodectomy does not
increase the risk of loco-regional cutaneous metastases of malignant
melanomas.
Eur J Cancer.
2005;
41
531-538
-
2
van Akkooi A CJ, de Wilt J HW, Verhoef C. et al .
High positive sentinel node
identification rate by EORTC melanoma group protocol. Prognostic indicators of
metastatic patterns after sentinel node biopsy in melanoma.
EJC.
2006;
42
372-380
-
3
Abrahamsen H N, Hamilton-Dutoit S J, Larsen J, Steiniche T.
Sentinel lymph nodes in malignant melanoma.
Extended histopathologic evaluation improves diagnostic precision.
Cancer.
2004;
100
1683-1691
-
4
Carlson G W, Murray D R, Lyles R H. et al .
The amount of metastatic melanoma in a
sentinel lymph node: does it have prognostic significance?.
Ann Surg Oncol.
2003;
10
575-581
-
5
Estourgie S H, Nieweg O E, Valdés Olmos R A. et al .
Review and evaluation of sentinel node
procedures in 250 melanoma patients with a median follow up of 6 years.
Ann Surg Oncol.
2003;
10
681-688
-
6
Gershenwald J E, Thompson W, Mansfiled P F. et al .
Multi-institutional melanoma lymphatic
mapping experience: The prognostic value of sentinel lymph node status in 612
stage I or II melanoma patients.
J Clin Oncol.
1999;
17
976-983
-
7
Vuylsteke R J, van Leeuwen P A, Statius Muller M G. et al .
Clinical outcome of stage I/II
melanoma patients after selective sentinel lymph node dissection: long-term
follow-up results.
J Clin Oncol.
2003;
21
1057-1065
-
8
Cascinelli N, Belli F, Santinami M. et al .
Sentinel lymph node biopsy in
cutaneous melanoma: the WHO Melanoma Program experience.
Ann Surg Oncol.
2000;
7
469-474
-
9
Cochran A J, Wen D R, Morton D L.
Occult tumor cells in the lymph nodes of patients
with pathalogical stage I malignant melanoma: an immunohistological study.
Am J Surg Pathol.
1988;
12
612-618
-
10
Cochran A J.
Surgical pathology remains pivotal in the
evaluation of ’sentinel’ lymph nodes.
Am J Surg Pathol.
1999;
23
169-1172
-
11
Cook M G, Green M A, Anderson B. et al .
The development of optimal
pathological assessment of sentinel lymph nodes for melanoma.
J Pathol.
2003;
200
314-319
-
12
Starz H, Balda B R, Krämer K U. et al .
A micromorphometry-based concept for
routine classification of sentinel lymph node metastases and its clinical
relevance for patients with melanoma.
Cancer.
2001;
91
2110-2121
-
13
Bieligk S C, Ghossein R, Bhattacharya S, Coit D G.
Detection of tyrosinase mRNA by reverse
transcription-polymerase chain reaction in melanoma sentinel nodes.
Ann Surg Oncol.
1999;
6
232-240
-
14
Ruiter D J, Spatz A, van den Oord J J, Cook M G,. Pathology Committee of the European Organization Research
and Treatment of Cancer (EORTC) Melanoma Group .
Pathologic staging
of melanoma.
Semin Oncol.
2002;
29
370-381
-
15
Kretschmer L, Bertsch H P, Meller J.
Sentinel lymph node biopsy in malignant
melanoma–an update.
J Dtsch Dermatol Ges.
2003;
1
777-784
-
16
Messina J L, Glass L F, Cruse C W. et al .
Pathologic examination of the sentinel
lymph node in malignant melanoma.
Am J Surg Pathol.
1999;
23
686-690
-
17
Cook M, di Palma S.
Our approach to pathology of sentinel lymph nodes
for melanoma.
J Clin Pathol.
2008;
61
897-902
-
18
Dewar D J, Newell B, Green M A. et al .
The microanatomic location of
metastatic melanoma in sentinel lymph nodes predicts nonsentinel lymph node
involvement.
J Clin Oncol.
2004;
22
3345-3349
-
19
van Akkooi A CJ, de Wilt J HW, Verhoef C. et al .
Clinical relevance of melanoma
micrometastases (< 0.1 mm) in sentinel nodes: are these nodes
to be considered negative?.
Ann Oncol.
2006;
17
1578-1585
-
20
Satzger I, Völker B, Meier A. et al .
Prognostic significance of isolated
HMB45 or Melan A positive cells in Melanoma sentinel lymph nodes.
Am J Surg Pathol.
2007;
31
1175-1180
Dr. med. Hans Peter Bertsch
Abteilung für Dermatologie und
Venerologie
Georg-August Universität Göttingen
Von-Siebold-Straße 3
37075 Göttingen
Email: derhigoe@med.uni-goettingen.de
