Peritumoral D2-40 Chalkley score independently predicts metastases and survival in patients with cutaneous malignant melanoma.
BACKGROUND
Many observational studies investigated the prognostic significance of angiogenesis and lymphangiogenesis in patients with melanoma. However, the obtained results are rather contradictory, probably due to the lack of the consensus methodology.


METHODS
To investigate the prognostic significance of angiogenesis and lymphangiogenesis-related parameters in patients with melanoma, we performed a retrospective investigation following the consensus recommendations for angiogenesis and lymphangiogenesis quantification in solid tumors and reporting recommendations for tumor marker (REMARK) criteria for reporting the results. Blood and lymphatic vessel Chalkley scores, endothelial cell proliferation fractions and microvessel densities were quantified using a double immunostaining for endothelial marker CD34 or lymphendothelial marker D240 and the proliferation marker Ki-67 in 196 patients with melanoma. These parameters were evaluated separately for peritumoral (PT) and intratumoral areas and were correlated with outcome.


RESULTS
In multivariate analysis PT D240 Chalkley score was identified as a strongest predictor for sentinel lymph node metastases, non-sentinel lymph node metastases, distant metastases, disease free survival and overall survival in patients with melanoma.


CONCLUSIONS
If additional studies corroborate our findings, we believe that the inclusion of PT D240 Chalkley counts to the routine pathology examination of melanoma samples would provide additional information for identifying high-risk patients.
Department of Dermatology, University Hospital 'Clínico Lozano Blesa', Zaragoza, Spain.
Ievgenia
I
Pastushenko
Translational Cancer Research Unit Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Wilrijk, Belgium.
Peter B
PB
Vermeulen
Department of Pathology, University Hospital 'Miguel Servet', Zaragoza, Spain.
Sandra
S
Vicente-Arregui
Translational Cancer Research Unit Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Wilrijk, Belgium.
Gert G
GG
Van den Eynden
Department of Pathology, University Hospital 'Miguel Servet', Zaragoza, Spain.
Ramiro
R
Alvarez-Alegret
Department of Medicine, Psychiatry and Dermatology, School of Medicine, University of Zaragoza, Zaragoza, Spain.
Ignacio
I
Querol
Translational Cancer Research Unit Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Wilrijk, Belgium.
Annemie
A
Rutten
Department of Medicine, Psychiatry and Dermatology, School of Medicine, University of Zaragoza, Zaragoza, Spain.
Francisco J
FJ
Carapeto
Translational Cancer Research Unit Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Wilrijk, Belgium.
Luc Y
LY
Dirix
Translational Cancer Research Unit Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Wilrijk, Belgium.|Department of Oncology, KU of Leuven, Leuven, Belgium.
Steven
S
Van Laere
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000737:chemistry; D018952:Antigens, CD34 / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008198:Lymph Nodes / Q000473:pathology; D042583:Lymphangiogenesis; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000473:pathology; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D012878:Skin Neoplasms / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology*; D016019:Survival Analysis; D042582:Vascular Endothelial Growth Factor C / Q000378:metabolism; D000096142:Cutaneous Malignant Melanoma
D058846:Antibodies, Monoclonal, Murine-Derived; D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D042582:Vascular Endothelial Growth Factor C; C500987:monoclonal antibody D2-40
Chalkley counting; angiogenesis; lymphangiogenesis; melanoma; prognosis