title: Microvascular lymphatic density analysis in cutaneous regressive and nonregressive superficial spreading melanomas using the lymphatic marker D2-40.
abstract: BACKGROUND
  The prognostic significance of spontaneous regression in melanoma, especially thin lesions, has been a controversial issue for the past 20 years, although recent studies suggest that extensive and late regression may be related to worse prognosis. Many data suggest that lymphangiogenesis predicts metastatic spread in melanoma.
  
  
  METHODS
  We have quantified lymphatic microvascular density (LMVD) in thin (≤ 1.0 mm) superficial spreading melanomas comparing regressive and nonregressive melanomas, regressive and nonregressive areas from the same tumor, and early and late histological stages of regression in the same tumor. In addition, we tried to correlate lymphangiogenesis and tumor growth phase. We conducted histological examinations and immunohistochemical analyses using monoclonal antibody D2-40 with subsequent quantification by image analysis of 37 melanomas, 16 regressive and 21 nonregressive (controls).
  
  
  RESULTS
  We found higher LMVD in the late stage of regression compared with nonregressive area (internal control) of regressive melanomas.
  
  
  CONCLUSIONS
  Our study suggest that the late stage of spontaneous regression in thin melanomas may be related to worse prognosis as it showed higher LMVD, and evidence shows that this is related with increased risk of metastatic spread. But this supposition must be confirmed by a longer follow-up for detection of lymph node metastases.
authors.affiliation: Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil. dermatol@uol.com.br
authors.forename: Helena Olegário
authors.initials: HO
authors.lastname: da Costa
authors.forename: Mirian N
authors.initials: MN
authors.lastname: Sotto
authors.forename: Neusa Yuriko Sakai
authors.initials: NY
authors.lastname: Valente
authors.forename: Luiz Fernando Ferraz
authors.initials: LF
authors.lastname: da Silva
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Sanches
authors.forename: Ana Maria Gonçalves
authors.initials: AM
authors.lastname: da Silva
authors.forename: Cyro
authors.initials: C
authors.lastname: Festa Neto
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007150:Immunohistochemistry; D042583:Lymphangiogenesis / Q000502:physiology; D042601:Lymphatic Vessels / Q000473:pathology*; D008297:Male; D008545:Melanoma / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009365:Neoplasm Regression, Spontaneous / Q000473:pathology; D011379:Prognosis; D012878:Skin Neoplasms / Q000378:metabolism / Q000473:pathology*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C500987:monoclonal antibody D2-40