title: Detection of Merkel cell virus and correlation with histologic presence of Merkel cell carcinoma in sentinel lymph nodes.
abstract: BACKGROUND
  Adjuvant treatment can dramatically improve the survival of patients with metastatic Merkel cell carcinoma (MCC), making early, accurate detection of nodal disease critical. The purpose of this study was to correlate Merkel cell virus (MCV) detection with histopathologic disease in sentinel lymph nodes (SLNs) of MCC.
  
  
  METHODS
  Merkel cell carcinoma cases with SLN (n=25) were compared with negative controls (n=27). Viral load was obtained by quantitative polymerase chain reaction (PCR) for regions VP1 and LT3 of MCV. Histopathologic disease and viral load were correlated.
  
  
  RESULTS
  Merkel cell virus was detected in 16 out of 17 (94%) of primary MCC (mean viral load (MVL)=1.44 copies per genome). Viral load in the negative controls was <0.01 copies per genome. Merkel cell carcinoma was present in 5 out of 25 (20%) SLN by histopathology, and MCV was detected in 11 out of 25 (44%) MCC SLN (MVL=1.68 copies per genome). In all, 15 out of 25 (60%) SLN showed correlation between histologic and MCV results. In all, 2 out of 25 (8%) samples were histopathologically positive and PCR negative. Of note, 8 out of 25 (32%) samples had detectable MCV without microscopic disease.
  
  
  CONCLUSIONS
  Patients with positive SLN for MCV even if negative by histopathology were identified. The application of molecular techniques to detect subhistologic disease in SLN of MCC patients may identify a subset of patients who would benefit from adjuvant nodal treatment.
authors.affiliation: Division of Head and Neck Cancer Research, Department of Otolaryngolgy Head and Neck Surgery, The Johns Hopkins School of Medicine, 1550 Orleans Street CRBII 5NC, Baltimore, MD 21321, USA. mloyo1@jhmi.edu
authors.forename: M
authors.initials: M
authors.lastname: Loyo
authors.forename: J
authors.initials: J
authors.lastname: Schussel
authors.forename: E
authors.initials: E
authors.lastname: Colantuoni
authors.forename: J
authors.initials: J
authors.lastname: Califano
authors.forename: M
authors.initials: M
authors.lastname: Brait
authors.forename: S
authors.initials: S
authors.lastname: Kang
authors.forename: W M
authors.initials: WM
authors.lastname: Koch
authors.forename: D
authors.initials: D
authors.lastname: Sidransky
authors.forename: W H
authors.initials: WH
authors.lastname: Westra
authors.forename: J M
authors.initials: JM
authors.lastname: Taube
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015266:Carcinoma, Merkel Cell / Q000473:pathology / Q000821:virology*; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D011120:Polyomavirus / Q000302:isolation & purification*; D021701:Sentinel Lymph Node Biopsy; D019562:Viral Load
chemical_list: D004279:DNA, Viral