title: Prognostic Implication of Lymphovascular Invasion Detected by Double Immunostaining for D2-40 and MITF1 in Primary Cutaneous Melanoma.
abstract: BACKGROUND
  Lymphovascular invasion (LVI) is associated with adverse outcomes in primary cutaneous melanoma (PCM). Detection of LVI by hematoxylin and eosin staining alone is 0%-6%, but targeting lymphovascular structures increases the detection rate.
  
  
  OBJECTIVE
  To examine the prognostic significance of LVI detected by immunostaining for D2-40 and microphthalmia-associated transcription factor 1 (MITF1) in PCM.
  
  
  METHODS
  The authors retrospectively analyzed 120 PCM samples. We compared the LVI detection rates of immunostaining for D2-40 only (22%), double staining for D2-40 and MITF1 (38%), and hematoxylin and eosin, and examined the association of LVI with clinicopathologic variables and clinical outcomes.
  
  
  RESULTS
  Immunolabeling with both methods significantly increased the LVI detection rate. Double staining for D2-40 and MITF1 as well as D2-40-detected LVI was significantly associated with increased Breslow thickness, number of mitoses, and sentinel lymph node (SLN) metastasis. D2-40-detected LVI was also associated with ulceration. Although the difference was not significant, double staining for D2-40 and MITF1 allowed for easier detection of LVI than D2-40 alone.
  
  
  CONCLUSIONS
  This study was conducted in a tertiary referral institution; therefore, a referral bias cannot be excluded.
  
  
  CONCLUSIONS
  Immunolabeling increased detection of LVI in PCM. Because LVI is a positive predictive marker for SLN metastasis, the authors propose using anti-D2-40 and anti-MITF1 in the evaluation of LVI in patients with PCM with a certain risk of SLN metastasis.
authors.affiliation: Departments of *Pathology, and †Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Laurence
authors.initials: L
authors.lastname: Feldmeyer
authors.forename: Michael
authors.initials: M
authors.lastname: Tetzlaff
authors.forename: Patricia
authors.initials: P
authors.lastname: Fox
authors.forename: Priyadharsini
authors.initials: P
authors.lastname: Nagarajan
authors.forename: Jonathan
authors.initials: J
authors.lastname: Curry
authors.forename: Doina
authors.initials: D
authors.lastname: Ivan
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Torres Cabala
authors.forename: Victor G
authors.initials: VG
authors.lastname: Prieto
authors.forename: Phyu P
authors.initials: PP
authors.lastname: Aung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000737:chemistry* / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000737:chemistry* / Q000473:pathology; D058950:Melanoma-Specific Antigens / Q000032:analysis*; D051739:Microphthalmia-Associated Transcription Factor / Q000032:analysis*; D008875:Middle Aged; D008938:Mitosis; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000737:chemistry* / Q000473:pathology; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; C497234:MITF protein, human; D058950:Melanoma-Specific Antigens; D051739:Microphthalmia-Associated Transcription Factor; C500987:monoclonal antibody D2-40