Increased Detection of Metastatic Melanoma in Pediatric Sentinel Lymph Node Biopsies Using RT-PCR on Paraffin-embedded Tissue
| Autor: | Alberto S. Pappo, Susan Chilton-MacNeill, Gino R. Somers, Maria Zielenska, Mary Stuart, Paul S. Thorner, Keqin Zheng |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Pathology medicine.medical_specialty Histology Adolescent Tyrosinase Sentinel lymph node Pathology and Forensic Medicine Biopsy Humans Medicine Clinical significance Child Melanoma Paraffin Embedding medicine.diagnostic_test Reverse Transcriptase Polymerase Chain Reaction Sentinel Lymph Node Biopsy business.industry medicine.disease body regions Medical Laboratory Technology Real-time polymerase chain reaction Child Preschool Immunohistochemistry Female Lymph business Follow-Up Studies |
| Zdroj: | Applied Immunohistochemistry & Molecular Morphology. 18:365-370 |
| ISSN: | 1541-2016 |
| DOI: | 10.1097/pai.0b013e3181ce1e61 |
| Popis: | Sentinel lymph node (SLN) biopsy has become integral in the staging of patients with melanoma, and entails detailed histologic examination with immunohistochemistry. Reverse transcriptase-polymerase chain reaction (RT-PCR) for tyrosinase transcripts has been used to increase sensitivity but requires a dedicated piece of tissue that does not undergo histologic examination. We developed a nested RT-PCR assay for tyrosinase applicable on paraffin-embedded tissue and applied this to a series of SLNs from pediatric patients with melanoma. Thirty-six SLNs from 4 females and 4 males were included in the study. Eight lymph nodes with reactive changes were included as controls. SLNs were examined histologically and immunohistochemically for S100, tyrosinase, and MART1. Seven patients had between 1 and 4 morphologically-positive SLNs and one patient had negative SLNs (HISTO+; 12/36, 33%). Three lymph nodes were excluded from molecular analysis owing to inadequate RNA, and 29 of the remaining 33 nodes were positive (MOL+; 88%). All patients had at least 1 SLN positive by RT-PCR. Twelve were HISTO+/MOL+; 17 were HISTO-/MOL+; and 4 were HISTO-/MOL-. All control lymph nodes were negative for tyrosinase transcripts. The application of RT-PCR for tyrosinase to paraffin-embedded tissue significantly increased the number of positive SLNs and upstaged one patient from negative to positive. The prognostic implications of such findings require further investigation, especially in the pediatric age group. Nonetheless, this technique provides a useful tool to determine the clinical significance of RT-PCR positivity in melanoma SLNs. |
| Databáze: | OpenAIRE |
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