Absence of Tumor-Infiltrating Lymphocyte Is a Reproducible Predictive Factor for Sentinel Lymph Node Metastasis: A Multicenter Database Study by the Brazilian Melanoma Group

作者：Duprat Joao Pedreira^*; Brechtbuelh Eduard Rene; de Sa Bianca Costa; Enokihara Mauro; Fregnani Jose Humberto; Landman Gilles; Maia Marcus; Riccardi Felice; Belfort Francisco Alberto; Wainstein Alberto; Moredo Luciana F; Steck Higino; Brandao Miguel; Moreno Marcelo; Miranda Eduardo; de Oliveira Santos Ivan Dunshee

来源：PLos One, 2016, 11(2): e0148160.

DOI：10.1371/journal.pone.0148160

Aims
The aim of this study is to confirm the function of tumor-infiltrating lymphocytes (TILs) in sentinel lymph node (SLN) metastasis.
Materials and Methods
This retrospective study included 633 patients with invasive melanoma who underwent sentinel lymph node biopsy in 7 referral centers certified by the Brazilian Melanoma Group. Independent risk factors of sentinel node metastasis (SNL) were identified by multiple logistic regression.
Results
SLN metastasis was detected in 101 of 633 cases (16.1%) and in 93 of 428 patients (21.7%) when melanomas <= 1mm were excluded. By multiple logistic regression, the absence of TILs was as an independent risk factor of SLN metastasis (OR = 1.8; 95% CI: 1.1-3.0), in addition to Breslow index (greater than 2.00 mm), lymph vascular invasion, and presence of mitosis.
Conclusion
SLNB can identify patients who might benefit from immunotherapy, and the determination of predictors of SLNB positivity can help select the proper population for this type of therapy. The absence of TILs is a reproducible parameter that can predict SLNB positivity in melanoma patients, since this study was made with several centers with different dermatopathologists.

• 出版日期2016-2-9