Markers usefulness in the melanic metastatic cellular epitops identification in the sentinel lymph node

Abstract

Cutaneous melanoma is the most severe skin neoplasia with an increased incidence in the recent decades, particularly due to the intense exposure to sunlight. Our study analyzed the characteristics of malignant melanoma and the role of sentinel node biopsy in the diagnosis and prognosis of the patients with cutaneous melanoma by identifying the regional metastasis. The small or large clusters of circulating cancer cells are expressing epitops identified by some chemical reaction. These reagents are usually monoclonal antibodies with high sensitivity and specificity which are matching with the right receptor from the melanoma cells. The result is an antibody-antigen complex high-light in the microscopic examination by 3,3'-diaminobenzidine (DAB). The study was conducted on a sample of 151 patients diagnosed with melanoma in different developmental stages: 62 had Breslow index between 1-4 mm, 71 patients had Breslow index à 4 mm and 18 patients had Breslow index < 1 mm. 45 patients (out of 62) with Breslow index between 1-4 mm had SLN positive. The mortality rate was 5% in the case of the patients with SLN positive. Comparing the rate of mortality by considering the Breslow index, 65% of the patients with Breslow index à 4 mm died. The correct identification of the patients with negative sentinel node or positive sentinel node improves staging and can facilitate the subsequent therapeutic decision, which is useful for early identification of the micro metastases and of the patients who require regional complete lymph node dissection.