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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Biopsy, Female, Forkhead Transcription Factors, Granzymes, Histocompatibility Antigens Class I, Humans, Lymphatic Metastasis, Lymphocyte Subsets, Lymphocytes, Tumor-Infiltrating, Male, Melanoma, Middle Aged.
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Is absence of Granzyme B positive tumour-infiltrating lymphocytes in primary melanoma excisional biopsies strongly associated with the presence of sentinel lymph node metastasis? Context: Sentinel Lymph Node (SLN) status is strongly related to clinical outcome in melanoma patients. In this study we investigated the possible association between the presence of activated and/or suppressive Tumour Infiltrating Lymphocytes (TILs) and SLN status in clinically stage I/II melanoma patients. Diagnostic primary melanoma samples from 20 patients with a sentinel lymph node metastasis were compared to melanoma samples from 20 patients with a negative sentinel lymph node, who were matched for gender, age and Breslow thickness. Presence of activated Granzyme B positive (GrB+) TILs, presence of suppressive (FoxP3+) TILs and MHC class I antigen expression on tumour cells were analysed by immunohistochemistry. FoxP3 and MHC-I expression had no direct bearing on the presence of melanoma metastases in the SLN. Whereas the presence of activated GrB+ TILs in the primary melanoma had no predictive value for SLN status either, their absence was strongly associated with the presence of metastasis in the SLN (p=0.001). While both GrB+ and FoxP3+ TILs could be detected in SLN metastases, a majority did not display MHC-I expression.
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These data support a role for cytotoxic T cells in the prevention of early metastasis of melanoma to the draining lymph nodes. Final Decision: yes