Immunohistochemical detection of lymphovascular invasion with D2-40 in melanoma correlates with sentinel lymph node status, metastasis and survival

J Cutan Pathol. 2009 Nov;36(11):1157-63. doi: 10.1111/j.1600-0560.2008.01242.x. Epub 2009 Feb 5.


Using immunohistochemistry with anti-D2-40 for the detection of lymphovascular invasion (LVI-IHC) in 74 cases of invasive melanoma, we found LVI in 23% (16/74) of the tumors. Data on sentinel lymph node (SLN) biopsy were available for 36 patients. Sixty-seven percent (6/9) of patients with LVI-IHC and 19% (5/27) without LVI-IHC had positive SLN. Follow-up data were available for 60 patients. Data on recurrence/metastasis were available for 60 patients. Twenty-five percent (15/60) had LVI with immunohistochemistry. Fifty-three percent (8/15) of these patients had "distant" metastasis or regional recurrence compared with 11% (5/45) in those without LVI-IHC. Overall and disease-specific survival was shorter for patients with LVI. In both the univariate and multivariate Cox proportional hazards regression models, LVI-IHC in addition to ulceration was statistically significant with respect to overall survival. Specifically, in the reduced multivariate model, compared with patients with no LVI, patients with intratumoral LVI had a hazard ratio (HR) of 5.4 (95% CI 1.6-18.4), while patients with peritumoral LVI had a HR of 3.8 (95% CI 0.7-20.9). In addition, patients with ulceration had an increased hazard of 4.4 (95% CI 1.2-16.8). For the first time, we herein show a positive correlation with LVI in melanoma detected with immunohistochemistry and distant metastasis, overall survival and disease-free survival.

MeSH terms

  • Antibodies, Monoclonal*
  • Antibodies, Monoclonal, Murine-Derived
  • Humans
  • Immunohistochemistry
  • Kaplan-Meier Estimate
  • Lymphatic Metastasis / pathology*
  • Melanoma / metabolism
  • Melanoma / mortality
  • Melanoma / pathology*
  • Sentinel Lymph Node Biopsy
  • Skin Neoplasms / metabolism
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology*


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • monoclonal antibody D2-40