title: Long-term protective effect of mature DC-LAMP+ dendritic cell accumulation in sentinel lymph nodes containing micrometastatic melanoma.
abstract: OBJECTIVE
  In a previous immunohistochemical study of dendritic cells (DC) in sentinel lymph nodes (SLN) draining regressing melanomas, we found that the accumulation of mature DC-LAMP(+) DCs in SLNs was associated with local expansion of antigen-specific memory effector CTLs and the absence of metastasis in downstream lymph nodes. The aim of this study was to investigate the prognostic importance of the maximal density of mature DCs in SLNs.
  
  
  METHODS
  A total of 458 consecutive patients with micrometastatic melanoma within SLNs were eligible for analysis. The maximal density of mature DC-LAMP(+) DCs was evaluated by three independent observers and categorized into three classes (<100, 100 to <200, and >or=200/mm(2)).
  
  
  RESULTS
  There was excellent interobserver reproducibility for maximum density of mature DC-LAMP(+) DC scores (kappa score = 0.82). There were differences in the maximal density scores and staining intensity according to the treating melanoma center (P < 0.001). The higher the mature DC density in the SLN is, the longer is the duration of survival [P = 0.047; hazard ratio, 0.70; 95% confidence interval, 0.50-1.00]. Adjusted by thickness and ulceration, the prognostic importance of DC density was lower (P = 0.36).
  
  
  CONCLUSIONS
  This study is the first to report the prognostic value of DC-LAMP(+) DC counts in SLNs containing metastatic melanoma. Patients with a high density of mature DCs (>or=200/mm(2)) have the lowest risk of death. It also provides evidence that a lack of maturation in the SLNs is important in biological facilitation of melanoma progression.
authors.affiliation: Royal Surrey County Hospital Guildford, Guildford, United Kingdom.
authors.forename: Bruce
authors.initials: B
authors.lastname: Elliott
authors.forename: Richard A
authors.initials: RA
authors.lastname: Scolyer
authors.forename: Stefan
authors.initials: S
authors.lastname: Suciu
authors.forename: Serge
authors.initials: S
authors.lastname: Lebecque
authors.forename: Donata
authors.initials: D
authors.lastname: Rimoldi
authors.forename: Oliver
authors.initials: O
authors.lastname: Gugerli
authors.forename: Elena
authors.initials: E
authors.lastname: Musat
authors.forename: Raghwa N
authors.initials: RN
authors.lastname: Sharma
authors.forename: Danielle
authors.initials: D
authors.lastname: Lienard
authors.forename: Ulrich
authors.initials: U
authors.lastname: Keilholz
authors.forename: Alessandro
authors.initials: A
authors.lastname: Testori
authors.forename: Alexander
authors.initials: A
authors.lastname: Eggermont
authors.forename: Rona
authors.initials: R
authors.lastname: MacKie
authors.forename: Caroline
authors.initials: C
authors.lastname: Robert
authors.forename: Martin
authors.initials: M
authors.lastname: Cook
authors.forename: John F
authors.initials: JF
authors.lastname: Thompson
authors.forename: Eric
authors.initials: E
authors.lastname: Angevin
authors.forename: Alain
authors.initials: A
authors.lastname: Spatz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003713:Dendritic Cells / Q000166:cytology*; D005260:Female; D006801:Humans; D051907:Lysosomal Membrane Proteins / Q000096:biosynthesis*; D008297:Male; D008545:Melanoma / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D008875:Middle Aged; D009362:Neoplasm Metastasis; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome
chemical_list: D051907:Lysosomal Membrane Proteins