Microvessel density, lymphovascular density, and lymphovascular invasion in primary cutaneous melanoma - Correlation with histopathologic prognosticators and BRAF status

The relationship between microvessel density (MVD), lymphovascular density (LVD), and lymphovascular invasion (LVI) in primary cutaneous melanoma (PCM) remains unclear. Given this, a total of 102 PCMs were assessed for MVD (vascular endothelial growth factor receptor 2 and Endocan), LVD (D2-40), and LVI (immunostaining with D2-40/S-100 and hematoxylin and eosin); tumoral S-100A13, vascular endothelial growth factor receptor 2, and Endocan; and BRAF status. LVD was associated with MVD (P =.01). MVD was higher in PCMs with depth greater than or equal to 2 mm and ulceration (P =.04,.05), whereas LVD was higher in PCMs with depth greater than or equal to 2 mm and mitoses (P =.03,.02). After adjusting for MVD and LVD, only ulceration was associated with LVI (P <.02). A BRAF mutation was seen in 30.4% cases, and when present, both LVD and host response (P =.0008 and.04, respectively) were significantly associated with MVD. Immunostaining with S-100A13 was noted in 99% of cases and a significant association noted only with ulceration (P =.05). Immunostaining increased LVI positivity (46.5% versus 4.9% by hematoxylin and eosin, P <.0001). MVD and LVD are not associated with LVI, appear to be closely related with each other, and are associated with select markers of poor prognosticative value. The association between a host response and LVD and MVD in PCMs with a BRAF mutation suggests that they exhibit potential for strategizing immunotherapies.