Механизм раннего лимфогенного метастазирования меланомы кожи

Federal State Budgetary Institution "Russian Scientific Center of Radiology and Surgical Technologies named after Academician A.M. Granova" Ministry of Health of Russia, St. Petersburg, Russia

https://orcid.org/0000-0001-9616-6635

Vladimir Anatolyevich Ershov

Municipal Clinical Oncology Dispensary, St.-Petersburg; Military Medical Academy names after S. M. Kirov, St.-Petersburg, Russia

https://orcid.org/0000-0002-8641-1489

Georgy Moyseevich Manikhas

First St. Petersburg Academician State Medical University named after I.P. Pavlov

https://orcid.org/0000-0002-5110-047X

Eldar Eskenderovych Topuzov

Municipal Clinical Oncology Dispensary, St.-Petersburg; Northwestern State Medical University named after I. I. Mechnikov of the Ministry of Health of the Russian Federation

https://orcid.org/0000-0002-1700-1128

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Keywords

skin melanoma
sentinel lymph nodes
lymph flow rate
metastases
lymphoscintigraphy

How to Cite

Anisimova, A. V., Vorob’eva, S. P., Manikhas , A. G., Ershov, V. A., Manikhas, G. M., & Topuzov, E. E. (2025). The Mechanism of Early Lymphogenic Metastasis of Skin Melanoma. Voprosy Onkologii, 71(4), OF–2337. https://doi.org/10.37469/0507-3758-2025-71-4-OF-2337

Abstract

Introduction. Lymphogenic metastasis remains the primary dissemination route for cutaneous melanoma, yet the underlying biological mechanisms and predictive factors remain poorly understood.

Aim. To evaluate lymph transit velocity as a prognostic marker for early lymphogenic metastasis in clinically localized cutaneous melanoma.

Materials and Methods. We analyzed clinical, dynamic lymphoscintigraphy, and histopathological (including histological, cytological, immunohistochemical, immunocytochemical) data from 30 patients with primary melanoma of the trunk/extremities.

Results. Lymph flow velocity differed significantly (p = 0.0002) between patients with metastatic vs. reactive sentinel lymph nodes (SLNs). Metastatic SLNs: 15.13 mm/sec (CI: 3.3–45) (n = 8). Reactive SLNs: 1.81 mm/sec (CI: 0.15–4.97; p < 0.05) (n = 22). A threshold velocity of 3.31 mm/sec predicted SLN metastasis with 87.5% sensitivity and 81.8% specificity (AUC >0.95). No difference in lymphatic vessel density was observed between localized and locoregional tumors. Metastatic SLNs exhibited 44% lower optical density in paranodal tissue vs. non-metastatic SLNs.

Conclusion. Dynamic lymphoscintigraphy-derived lymph flow velocity is a clinically actionable predictor of lymphogenic metastasis in cutaneous melanoma.

https://doi.org/10.37469/0507-3758-2025-71-4-OF-2337

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##article.numberofviews## 16

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