Details

Autor(en) / Beteiligte

• Ricci, Costantino
• Dika, Emi
• Lambertini, Martina
• Ambrosi, Francesca
• Grillini, Marco
• Chillotti, Stefano
• Corradini, Angelo Gianluca
• Veronesi, Giulia
• Fiorentino, Michelangelo
• Corti, Barbara

Titel

Hematoxylin and eosin or double stain for CD34/SOX10: Which is better for the detection of lymphovascular invasion in cutaneous melanoma?

Ist Teil von

• Pathology, research and practice, 2022-05, Vol.233, p.153876-153876, Article 153876

Ort / Verlag

Germany: Elsevier GmbH

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• Lymphovascular invasion (LVI) is considered an unfavorable prognostic factor in cutaneous melanoma (CM). However, its detection by hematoxylin and eosin (H&E) is challenging, with discordant data about its association with clinical-pathological features and no previous studies investigating the inter- (IrOA) and intra-observer (IaOA) agreement. Herein, we tested H&E and double staining (DS) for CD34/SOX10 to detect the LVI in a cohort of 92 CMs, evaluating the IrOA, the IaOA, and the association with the other clinical-pathological features. Five authors independently evaluated 92 consecutive and retrospectively enrolled cases of CMs. We assessed the IrOA (Fleiss’s Kappa/FK and intraclass correlation coefficient/ICC) and the IaOA (Cohen’s Kappa/CK) with both H&E and CD34/SOX10. Furthermore, we compared the LVI assessment with the two stains and analyzed the association with other clinical-pathological features [χ2 tests for dichotomous and categorical data; Student t-test (normal distribution) and Mann-Whitney U-test (non-normal distribution) for continuous data]. The IrOA was almost identical with H&E (FK=0.446; ICC=0.805) and CD34/SOX10 (FK=0.454; ICC=0.810); by contrast, the IaOA was higher with H&E for one pathologist (CK: 0.809) and with CD34/SOX10 for the other one (CK: 0.563). Applying previously defined criteria, LVI was detected in 10 (9.2%) and 11 (10.1%) cases with H&E and CD34/SOX10, respectively (p = 1.000). Both H&E and CD34/SOX10 were significantly associated with vertical growth phase (H&E, p: 0.014; CD34/SOX10, p: 0.010), mitosis ≥ 1/mm2 (H&E, p: 0.000; CD34/SOX10, p: 0.004), pT (H&E, p: 0.000; CD34/SOX10, p: 0.001), Breslow thickness (H&E, p: 0.000; CD34/SOX10, p: 0.001), and lymph node and/or distant metastasis (H&E, p: 0.005; CD34/SOX10, p: 0.000); only H&E was associated with ulceration (p: 0.002) and distant metastasis (p: 0.000), conversely, only CD34/SOX10 was associated with lymph node metastasis (p: 0.003). CD34/SOX10 does not improve the IrOA and the IaOA of the LVI assessment in CM; furthermore, H&E and CD34/SOX10 show a similar profile of association with the other unfavorable clinical-pathological features of CM. As result, CD34/SOX10 could be a redundant diagnostic tool if applied for the prognostic characterization of not-selected CM in a routine diagnostic scenario. •CD34/SOX10 does not increase the inter-observer agreement between dermatopathologists (DPs) and non-DPs.•CD34/SOX10 provides peculiar and unexpected results regarding the intra-observer agreement between DPs and non-DPs.•Adopting strictly defined criteria and with consensus review, CD34/SOX10 does not increase LVI detection.•H&E and CD34/SOX10 were associated with unfavorable features (growth phase, mitoses, pT, Breslow and metastases).