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Lee KH, Suh HY, Lee MW, Lee WJ, Chang SE. Prognostic Significance of Epidermal Growth Factor Receptor Expression in Distant Metastatic Melanoma from Primary Cutaneous Melanoma. Ann Dermatol 2021; 33:432-439. [PMID: 34616124 PMCID: PMC8460484 DOI: 10.5021/ad.2021.33.5.432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 02/09/2021] [Accepted: 02/22/2021] [Indexed: 11/21/2022] Open
Abstract
Background Epidermal growth factor receptor (EGFR) is overexpressed in many cancers. However, EGFR expression in melanoma and its role are conflicting. Objective This study aimed to evaluate EGFR expression in distant metastatic melanoma and analyze its relationship with histologic and clinical characteristics and survival. Methods Diagnostic tissues from 55 cases of distant metastatic melanoma was evaluated by immunohistochemistry for EGFR expression. Clinicopathologic features and survival outcomes were analyzed according to EGFR expression. Results The positive EGFR expression in distant metastatic melanoma was significantly correlated with the absence of ulceration. The EGFR expression in distant metastatic melanoma was significantly associated with poor survival, under the conditions of male sex and primary cutaneous melanoma without ulceration or Breslow thickness ≤4.0 mm. This study bears limitations of a retrospective study in a single institution. Conclusion EGFR immunostaining had predictive values for survival outcome. The EGFR expression in distant metastatic melanoma in male, no ulcer, or Breslow thickness ≤4.0 mm appeared to be involved in disease progression.
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Affiliation(s)
- Keon Hee Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Yi Suh
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Yun WJ, Bang SH, Min KH, Kim SW, Lee MW, Chang SE. Epidermal Growth Factor and Epidermal Growth Factor Signaling Attenuate Laser-Induced Melanogenesis. Dermatol Surg 2013; 39:1903-11. [DOI: 10.1111/dsu.12348] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Boone B, Jacobs K, Ferdinande L, Taildeman J, Lambert J, Peeters M, Bracke M, Pauwels P, Brochez L. EGFR in melanoma: clinical significance and potential therapeutic target. J Cutan Pathol 2011; 38:492-502. [PMID: 21352258 DOI: 10.1111/j.1600-0560.2011.01673.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND The role of epidermal growth factor receptor (EGFR) has been established in a range of neoplasms. In melanoma, data on EGFR protein expression are conflicting. Fluorescence in situ hybridization (FISH) analysis for EGFR gene expression in melanoma showed EGFR gene amplification to be linked with worse prognosis. Cetuximab has been shown to suppress the formation of metastasis in mice. METHODS EGFR protein expression and gene copy number status were evaluated by means of immunohistochemistry and FISH in melanoma samples of patients with known clinicopathological data. Associations between EGFR expression and prognostic parameters were investigated. The effect of different cetuximab concentrations on the BLM melanoma cell line was evaluated by means of methyl tetrazolium (MTT), sulforhodamine B (SRB) and Matrigel invasion assays. RESULTS EGFR protein expression was more frequently observed in patients with a positive sentinel lymph node. However, EGFR immunostaining has no predictive value. The presence of EGFR polysomy was associated with thicker tumors. Treatment of the BLM melanoma cell line with different concentrations of cetuximab reduced the invasive capacity of the cells, but did not alter cell viability or growth. CONCLUSION EGFR appears to be involved in progression and metastasis of a subset of melanomas. Targeting EGFR could therefore represent a therapeutic option for these melanomas.
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Affiliation(s)
- Barbara Boone
- Department of Dermatology, University Hospital Ghent, Ghent, Belgium.
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Different Patterns of Expression of the erbB Family of Receptor Tyrosine Kinases in Common Nevi, Dysplastic Nevi, and Primary Malignant Melanomas: An Immunohistochemical Study. Am J Dermatopathol 2010; 32:665-75. [DOI: 10.1097/dad.0b013e3181d1e6f0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Correlation of clinicopathological parameters with HGF, c-Met, EGFR, and IGF-1R expression in uveal melanoma. Melanoma Res 2010; 20:126-32. [PMID: 20061986 DOI: 10.1097/cmr.0b013e328335a916] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study evaluated the expression profile of hepatocyte growth factor (HGF), c-Met, epidermal growth factor receptor (EGFR), insulin-like growth factor-1 receptor (IGF-1R), and vitreal and serum EGF, HGF, IGF-1 levels in patients with uveal melanoma and assessed their correlation with the clinicopathological parameters. Forty patients with uveal melanoma were included in the study. Clinicopathological parameters were evaluated with hematoxylin-eosin staining. HGF, c-Met, EGFR, and IGF-1R expressions were evaluated immunohistochemically. HGF, EGF, and IGF-1 levels were measured with enzyme-linked immunosorbent assay in vitreous and serum specimens taken at enucleation and 6 months after the enucleation. HGF, c-Met, IGF-1R, and EGFR expressions were detected in 57.5, 20, 20, and 12.5% of cases, respectively. IGF-1R expression was significantly correlated with the degree of pigmentation, necrosis, and lymphocyte infiltration (P=0.013, 0.04, and 0.017). EGFR expression was significantly correlated with the mitosis rate (P=0.02). Vitreal EGF and serum IGF-1 levels were significantly higher in patients with scleral invasion (15.72+/-29.13, 199.01+/-154.01 pg/ml, respectively) when compared with the patients without invasion (0.56+/-1.05, 33.01+/-36.52 pg/ml) (P=0.03 and 0.015). When the preoperative and postoperative serum growth factor levels were compared, the serum EGF level was found to be lower (125.93+/-62.84, 100.02+/-31.19 pg/ml, P=0.007) and the serum IGF-1 level (165.81+/-153.6, 301.35+/-131.24 pg/ml, P<0.001) was found to be higher in the postoperative 6-month specimens. Uveal melanomas express HGF, c-Met, EGFR, and IGF-1R. Vitreal growth factor levels and expression of EGFR and IGF-1R are correlated with some clinicopathological parameters. IGF-1 and EGF may have a role in the development and progression of uveal melanoma.
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Kwong L, Chin L, Wagner SN. Growth factors and oncogenes as targets in melanoma: lost in translation? ACTA ACUST UNITED AC 2008; 23:99-129. [PMID: 18159898 DOI: 10.1016/j.yadr.2007.07.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Lawrence Kwong
- Department of Medical Oncology, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115, USA
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Eberle J, Kurbanov BM, Hossini AM, Trefzer U, Fecker LF. Overcoming apoptosis deficiency of melanoma-hope for new therapeutic approaches. Drug Resist Updat 2007; 10:218-34. [PMID: 18054518 DOI: 10.1016/j.drup.2007.09.001] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Revised: 09/02/2007] [Accepted: 09/07/2007] [Indexed: 11/16/2022]
Abstract
The increased incidence of malignant melanoma in the last decades, its high mortality and pronounced therapy resistance pose an enormous challenge. Important therapeutic targets for melanoma are the induction of apoptosis and suppression of survival pathways. Preclinical studies have demonstrated the efficacy of pro-apoptotic Bcl-2 proteins and of death receptor ligands to trigger apoptosis in melanoma cells. In the clinical setting, BH3 domain mimics and death receptor agonists are therefore considered as promising, specific novel treatments to add to the conventional pro-apoptotic strategies such as chemo- or radiotherapy. However, constitutively activated survival pathways, in particular the mitogen-activated protein kinases, protein kinase B/Akt and nuclear factor (NF)-kappaB, all may work in concert to prevent effective therapy. Thus, selective biologicals developed with the aim to inhibit pro-survival signaling are currently tested in melanoma. For highly therapy-resistant tumors such as melanoma, development of novel drug combinations will be essential, and combinations of survival inhibitors and pro-apoptotic mediators appear most promising. The challenge of the near future will be to make a rational choice of the multiple possible combinations and protocols. This review gives a critical overview of proteins involved in melanoma chemoresistance, which are targets for current drug development leading to the best choice for future trials.
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Affiliation(s)
- Jürgen Eberle
- Charité-Universitätsmedizin Berlin, Department of Dermatology and Allergy, Skin Cancer Center Charité, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
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Akilov OE, Donovan MJ, Stepinac T, Carter CR, Whitcomb JP, Hasan T, McDowell MA. T helper type 1 cytokines and keratinocyte growth factor play a critical role in pseudoepitheliomatous hyperplasia initiation during cutaneous leishmaniasis. Arch Dermatol Res 2007; 299:315-25. [PMID: 17643254 DOI: 10.1007/s00403-007-0765-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2006] [Revised: 06/14/2007] [Accepted: 06/17/2007] [Indexed: 11/30/2022]
Abstract
Pseudoepitheliomatous hyperplasia (PEH) is an exuberant proliferation of the epidermis. The underlying mechanism(s) that lead to PEH have not been completely elucidated. Here, we characterize PEH during the healing stages of cutaneous leishmanial ulcers in mice. During experimental cutaneous leishmaniasis (CL) C57BL/6 mice produce PEH, and BALB/c do not. A series of immunohistochemical and immunological studies were performed to identify the secretory products of PEH regulation. We observed that the distribution of TNF-alpha and IFN-gamma under PEH had a stripe-like diffuse pattern and localized in the upper part of the papillary dermis directly under the proliferating epidermis. Macrophages were identified as the major source of TNF-alpha (56.3%). The importance of IFN-gamma and TNF-alpha in PEH development was proven by the initiation of PEH after three intralesional injections of TNF-alpha and IFN-gamma every three days in infected BALB/c mice. In C57BL/6 mice, keratinocyte growth factor (KGF) expressing cells were found immediately under the basal membrane of the hyperplastic epidermis in comparison with sporadic KGF positive cells deep in the dermis of BALB/c mice. Quantitative RT-PCR analysis demonstrated increased KGF and KGF receptor expression in uninfected C57BL/6 mice as compared to BALB/c mice. These data indicate that Th1 cytokines and KGF play a critical role in PEH initiation during CL.
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Affiliation(s)
- Oleg E Akilov
- Center for Global Health and Infectious Diseases, Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46656, USA
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Spanjaard RA, Whren KM, Graves C, Bhawan J. Tumor necrosis factor receptor superfamily member TROY is a novel melanoma biomarker and potential therapeutic target. Int J Cancer 2007; 120:1304-10. [PMID: 17187358 DOI: 10.1002/ijc.22367] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Incidence of melanoma continues to rise, and a better understanding of its genetics will be critical to improve diagnosis and develop new treatments. Here, we search for novel melanoma-specific genes that may serve as biomarkers and therapeutic targets by using an in vitro genetic screen. One identified cDNA encoded TROY, a member of the tumor necrosis factor receptor superfamily (TNFRSF). TROY is widely expressed during embryogenesis, but in adults expression is restricted to hair follicles and brain. However, TROY had never been associated with melanoma, and it was selected for further study. First we show that expression in melanoma is specific by semiquantitative RT-PCR analysis of a large panel of established tumor cell lines. Next, specificity of expression was evaluated by immunohistochemistry analysis of primary cell cultures and patient tissues. TROY is expressed in 2/2 primary melanoma cells and 45/45 melanoma tissue samples (p < 0.0001). With the exception of sebaceous glands, TROY is not expressed in normal skin biopsies (p < 0.0001) or primary skin cell cultures that contain keratinocytes and epidermal melanocytes, nor is it expressed in other skin tumor cells (p < 0.0001). Finally, we show that TROY regulates melanoma growth, because replication of melanoma cells with reduced TROY levels through treatment with short-interfering RNA was significantly decreased relative to control cells (p < 0.004). In summary, TROY is the first TNFRSF member that is a biomarker for melanoma. TROY also presents a potentially novel cell surface signaling target for inhibitors, cell and/or antibody-based immunotherapies.
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MESH Headings
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Cell Line, Tumor
- Cell Proliferation
- Gene Expression Regulation, Neoplastic
- Humans
- Immunohistochemistry
- Melanocytes/chemistry
- Melanocytes/metabolism
- Melanocytes/pathology
- Melanoma/chemistry
- Melanoma/metabolism
- Melanoma/pathology
- RNA, Messenger/analysis
- RNA, Messenger/metabolism
- Receptors, Tumor Necrosis Factor/analysis
- Receptors, Tumor Necrosis Factor/genetics
- Receptors, Tumor Necrosis Factor/metabolism
- Skin/chemistry
- Skin/metabolism
- Skin/pathology
- Skin Neoplasms/chemistry
- Skin Neoplasms/metabolism
- Skin Neoplasms/pathology
- TNF Receptor-Associated Factor 6/analysis
- TNF Receptor-Associated Factor 6/metabolism
- Tretinoin/metabolism
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Affiliation(s)
- Remco A Spanjaard
- Department of Otolaryngology, Cancer Research Center, Boston University School of Medicine, 715 Albany Street, Boston, MA 02118, USA.
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Szabad G, Kormos B, Pivarcsi A, Széll M, Kis K, Kenderessy Szabó A, Dobozy A, Kemény L, Bata-Csörgo Z. Human adult epidermal melanocytes cultured without chemical mitogens express the EGF receptor and respond to EGF. Arch Dermatol Res 2007; 299:191-200. [PMID: 17334773 DOI: 10.1007/s00403-007-0742-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2006] [Revised: 02/02/2007] [Accepted: 02/05/2007] [Indexed: 01/23/2023]
Abstract
We describe a novel chemical mitogen-free in vitro culture technique for obtaining pure melanocyte cultures using normal human adult epidermis as a source. The culture medium consists equal parts of the commercially available Keratinocyte Basal and AIM-V media (both from Gibco), as basal medium, which is supplemented with fetal bovine serum, bovine pituitary extract and recombinant human epidermal growth factor (EGF). Melanocytes harvested from human adult skin proliferate extensively and can be passaged serially up to 10-15 times using this medium. We have verified the identity of the cultured cells by tyrosinase mRNA expression and TRP-1 protein staining. Moreover, we showed that autologous human serum alone, without additional supplements is able to provide sufficient growth support for the cultured cells in the basal medium, making this culture technique suitable for autologous melanocyte transplantation. In this culture system normal human adult melanocytes expressed both EGF receptor (EGFR) mRNA and protein and EGF showed a dose dependent mitogenic effect on the cells. EGF itself had no significant influence on EGFR mRNA expression.
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Affiliation(s)
- Gábor Szabad
- Faculty of Medicine, Department of Dermatology and Allergology, University of Szeged, 6720 Szeged, Korányi fasor 6, Hungary
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Ribeiro R, Soares A, Pinto D, Catarino R, Lopes C, Medeiros R. EGF genetic polymorphism is associated with clinical features but not malignant phenotype in neurofibromatosis type 1 patients. J Neurooncol 2006; 81:225-9. [PMID: 17031562 DOI: 10.1007/s11060-006-9224-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2006] [Accepted: 07/18/2006] [Indexed: 12/22/2022]
Abstract
Neurofibromatosis type 1 (NF1) is characterized by a wide variation in clinical presentation and in some cases progression to malignant tumor. Epidermal growth factor (EGF) is an important mitogen for Schwann cells and is involved in the development of malignant tumors in NF1 patients. We hypothesized that EGF +61 G/A functional polymorphism, which represents constitutional all-life exposure to higher EGF expression and circulating levels, may predispose for precocious and more aggressive manifestations of disease. We found that clinical findings of intestinal polyps are significantly more frequent in patients with G homozygous genotype (P = 0.023). Those carriers of GG genotype have earlier onset of café-au-lait spots and Lisch nodules appearance (P = 0.030 and P = 0.017, respectively). Nevertheless, the EGF overexpressing genotype-GG, is not associated with higher risk for malignant progression or severity of disease. EGF polymorphism may play a role in the earlier onset of NF1 pigment cell-related manifestations and in intestinal polyps' development. Further studies in larger samples should confirm the absence of risk for having higher severity grade or malignant phenotype in NF1 patients.
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Affiliation(s)
- Ricardo Ribeiro
- Molecular Oncology-CI, Portuguese Institute of Oncology, Edifício Laboratórios-PISO 4, R. Dr. Ant. Bernardino Almeida, 4200-072, Porto, Portugal
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Abstract
Angiogenesis is a hallmark of melanoma progression. Antiangiogenic agents have been infrequently tested in patients with advanced melanoma. Experience with most other cancers suggests that single-agent application of angiogenic inhibitors is unlikely to have substantial clinical antitumor activity in melanoma. It is more likely that combinations of antiangiogenic agents with either chemotherapy or other targeted therapy will be needed to produce significant clinical benefit. In melanoma, numerous cellular pathways important to cell proliferation, apoptosis, or metastases have recently been shown to be activated. Activation occurs through specific mutations (B-RAF, N-RAS, and PTEN) or changes in expression levels of various proteins (PTEN, BCL-2, NF-kappaB, CDK2, and cyclin D1). Agents that block these pathways are rapidly entering the clinical setting, including RAF inhibitors (sorafenib), mitogen-activated protein kinase inhibitors (PD0325901), mammalian target of rapamycin inhibitors (CCI-779), and farnesyl transferase inhibitors (R115777) that inhibit N-RAS and proteasome inhibitors (PS-341) that block activation of nuclear factor-kappaB (NF-kappaB). It will be a challenge to evaluate these agents alone, in combination with each other, or with chemotherapy in patients with melanoma. Trials with large populations of biologically ill-defined tumors run the risk of missing clinical antitumor activity that is important for a particular yet-to-be-defined subset of patients. To rationally and optimally develop these targeted agents, it will be critical to adequately test for the presence of the presumed cellular target in tumor specimens and the effect of therapy on the proposed target (biological response). Investigators in this field will need to carefully plan these trials so that at the end of the day, we learn from both the failures and successes of targeted therapy.
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Affiliation(s)
- Jeffrey A Sosman
- Vanderbilt-Ingram Cancer Center, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA.
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Fröhlich E, Mack AF, Garbe C, Klessen C. Distribution and colocalization of markers for proliferation, invasion, motility and neoangiogenesis in benign melanocytic naevi and malignant melanomas. Br J Dermatol 2005; 153:1159-65. [PMID: 16307652 DOI: 10.1111/j.1365-2133.2005.06883.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Melanomas are heterogeneous tumours, and differentiation from other melanocytic lesions may cause problems. It may be possible that the distribution and/or colocalization pattern of different markers in the lesions can enable a more accurate diagnosis of melanocytic tumours. OBJECTIVES To test this hypothesis, melanocytic naevi, primary melanomas and metastases were investigated. METHODS The distribution and colocalization of markers for proliferation, invasion, angiogenesis and motility of the tumour cells were investigated using antibodies directed against actin, cathepsin B (CatB), transforming growth factor-beta, vascular endothelial growth factor (VEGF), proliferating cell nuclear antigen/Ki-67 and basic fibroblast growth factor (FGF-2). In addition, melanoma markers (HMB-45 and Melan-A) and proteins unrelated to melanoma progression [epidermal growth factor (EGF) and cathepsin H] were investigated. RESULTS Malignant melanomas tended to express more markers of malignancy compared with melanocytic naevi, and the differences were statistically significant for EGF and actin immunoreactivity: melanocytic naevi displayed clear EGF labelling more often (60% vs. 5%) and melanomas showed more intense actin labelling (70% vs. 0%). HMB-45+ cells to a large extent also stained with antibodies to CatB but not to EGF or actin; EGF-, FGF-2- and VEGF-immunoreactive cells were predominantly HMB-45-. Similar combinations were observed in melanocytic naevi and in melanomas. CONCLUSIONS Labelling with EGF may improve the differential diagnosis of melanocytic neoplasias. However, we did not detect a clear-cut increase of markers of malignancy in melanoma. Cells expressing multiple malignancy markers were also found in some melanocytic naevi; this may confirm the dormant potential of melanocytic naevi for melanoma development.
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Affiliation(s)
- E Fröhlich
- Anatomisches Institut, Osterbergstrasse 3, 72074 Tübingen, Germany.
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Mirmohammadsadegh A, Hassan M, Gustrau A, Doroudi R, Schmittner N, Nambiar S, Tannapfel A, Ruzicka T, Hengge UR. Constitutive Expression of Epidermal Growth Factor Receptors on Normal Human Melanocytes. J Invest Dermatol 2005; 125:392-4. [PMID: 16098054 DOI: 10.1111/j.0022-202x.2005.23772.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Mott RT, Rosenberg A, Livingston S, Morgan MB. Melanoma associated with pseudoepitheliomatous hyperplasia: a case series and investigation into the role of epidermal growth factor receptor. J Cutan Pathol 2002; 29:490-7. [PMID: 12207743 DOI: 10.1034/j.1600-0560.2002.290807.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Pseudoepitheliomatous hyperplasia (PEH) is a reactive epithelial proliferation that occurs in response to underlying infectious, inflammatory, and neoplastic conditions. The histologic features of PEH may simulate squamous cell carcinoma and may obscure an underlying malignant process. The association of PEH with benign melanocytic nevi is well described in the literature. However, reports documenting the association of PEH with melanoma are rare. METHODS We examined the demographic and histologic features in 13 cases of melanoma in association with PEH. In addition, we evaluated the possible pathogenic role of epidermal growth factor receptor (EGFR) using immunohistochemical methods. RESULTS In each case, histologic examination revealed epidermal hyperplasia with irregular cords of well-differentiated epithelial cells extending into the dermis and infiltrating the melanoma. Although overlap existed, two patterns of epidermal hyperplasia were noted. The majority of cases (69%) exhibited acanthosis, hyperkeratosis, papillomatosis, and irregular infiltrating epithelial cords with squamous eddies. The remaining cases demonstrated basaloid acanthosis, laminated orthokeratosis, and horn cysts. EGFR immunohistochemical studies revealed strong staining within the basal layer of the epithelium, with no discernible difference between the hyperplastic epithelium overlying the melanoma cells and adjacent normal skin. Immunostaining among the melanoma cells was absent to weak in each of the cases. All cases exhibited intense EGFR immunoreactivity in macrophages underlying the epidermal lesions. CONCLUSIONS Melanoma is capable of presenting in a variety of histologic guises, including a pattern with PEH. The etiology of PEH, as rarely seen in conjunction with melanoma, unlikely involves EGFR and remains to be elucidated.
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Affiliation(s)
- Ryan T Mott
- Department of Pathology, University of South Florida College of Medicine, Tampa, Florida, USA
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Slominski A, Wortsman J, Carlson AJ, Matsuoka LY, Balch CM, Mihm MC. Malignant melanoma. Arch Pathol Lab Med 2001; 125:1295-306. [PMID: 11570904 DOI: 10.5858/2001-125-1295-mm] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT The rapidly developing fields of melanoma research are revolutionizing the current concepts on melanoma etiology and pathogenesis and are introducing newer diagnostic techniques and potential therapeutic approaches. OBJECTIVES To present the most current concepts on the etiology and pathogenesis of melanoma and to introduce the recent diagnostic techniques and the potential therapeutic approaches. METHODS Data sources were reports on melanoma published in the English language literature and observations made using specimens available at Harvard University, Johns Hopkins Medical Center, Albany Medical College, Loyola University Medical Center, and University of Tennessee Health Science Center. RESULTS Studies on melanoma containing chromosomal or genetic evaluation were selected for further analysis. Current clinical and pathologic categories with the reported genetic abnormalities were related to the latest information on pigment biology. The data extracted were used to develop a conceptual framework on the pathogenesis of melanoma; the generated model was then evaluated and used to suggest potential therapeutic approaches. CONCLUSIONS (1) Melanoma is not genetically homogeneous, and the existing differences between the pathologic categories, particularly in areas such as type of growth phase (radial vs vertical growth), total vertical dimension, ulceration of primary tumor, and metastatic process, have profound prognostic and therapeutic implications. (2) Chromosomal aberrations and gene mutations are found in sporadic and familial melanomas; among the most important are those affecting the 9p21, which contains the p16 locus, a site known to be critical for normal progression of the cell cycle. Aberrant p16 expression is associated with more aggressive behavior. (3) Melanoma cells possess a remarkable repertoire of biosynthetic capacities represented by the production of hormones, growth factors, and their receptors that may sustain and accelerate tumor development and progression. For example, expression of the tumoral products alpha-melanocyte-stimulating hormone and adrenocorticotropic hormone is regulated in vitro by ultraviolet light, a known carcinogen. (4) Melanomas differ from other tumors in their intrinsic capability to express melanogenic enzymes with the corresponding structural proteins to actually synthesize melanin. Melanogenesis-related proteins are rapidly entering the clinical arena, being used not only as diagnostic markers, but also as potential targets for melanoma therapy.
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Affiliation(s)
- A Slominski
- Department of Pathology, University of Tennessee Health Sciences Center, Memphis 38163, USA.
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Gordon-Thomson C, Mason RS, Moore GP. Regulation of epidermal growth factor receptor expression in human melanocytes. Exp Dermatol 2001; 10:321-8. [PMID: 11589729 DOI: 10.1034/j.1600-0625.2001.100504.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The epidermal growth factor receptor (EGFR) and its ligand, transforming growth factor alpha (TGFalpha), are reportedly involved in autocrine growth of melanoma cells. The signal pathway has also been implicated in early events of transformation, suggesting a function for EGFR in normal cells. This study reports the presence of EGFR in cultured melanocytes and examines some cellular responses to TGFalpha. Western analysis revealed 170 kDa bands in extracts of cultured neonatal human melanocytes, corresponding to the receptor Mr. Protein expression was more pronounced in cells during active growth. EGFR were less evident in cultures populated predominantly by melanized cells, indicating that receptor expression became reduced in differentiating cells. Immunocytochemistry confirmed these observations and also showed that EGFR reactivity was predominantly localized in the cell body but absent from dendrites. Addition of TGFalpha to early cultures induced a rapid increase in phosphotyrosine signal of the 170 kDa protein. Longer treatment (24-48 h) increased the intensity of the EGFR signal, suggesting that receptors had been upregulated. However, inclusion of TGFalpha in cultures did not result in an increase in cell numbers when compared to controls. The observations provide evidence of the existence of a receptor-mediated pathway in melanocytes which has transforming potential in vivo.
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Affiliation(s)
- C Gordon-Thomson
- School of Science, University of Western Sydney, Parramatta Campus, Locked Bag 1797, Penrith South, DC 1797, Australia.
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Scarisbrick JJ, Calonje E, Orchard G, Child FJ, Russell-Jones R. Pseudocarcinomatous change in lymphomatoid papulosis and primary cutaneous CD30+ lymphoma: a clinicopathologic and immunohistochemical study of 6 patients. J Am Acad Dermatol 2001; 44:239-47. [PMID: 11174381 DOI: 10.1067/mjd.2001.110875] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We report 6 cases of pseudoepitheliomatous hyperplasia (PEH) mimicking squamous cell carcinoma in association with an atypical CD30+ dermal infiltrate. Three patients had lymphomatoid papulosis type A, and 3 patients had cutaneous CD30+ lymphoma. All 6 cases showed histologic evidence of PEH with keratinocyte atypia. In 4 cases there was significant atypia to prompt a diagnosis of squamous cell carcinoma. Three of these received treatment with wide local excision and 2 had been engrafted. Immunohistochemical staining for epidermal growth factor (EGF) and transforming growth factor alpha (TGF-alpha) showed similar expression in lesional and perilesional skin. Epidermal growth factor receptor (EGFR) expression by the proliferating epithelium was similar to that of the suprabasal adjacent normal epidermis. There was no aberrant expression of EGF, TGF-alpha, and EGFR by atypical lymphocytes. These cases demonstrate that PEH associated with CD30+ lymphoproliferative disease may closely resemble squamous cell carcinoma, thereby leading to inappropriate diagnosis and treatment.
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Affiliation(s)
- J J Scarisbrick
- Skin Tumour Unit, St John's Institute Dermatology, St Thomas' Hospital, London, UK.
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21
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Bardeesy N, Wong KK, DePinho RA, Chin L. Animal models of melanoma: recent advances and future prospects. Adv Cancer Res 2000; 79:123-56. [PMID: 10818679 DOI: 10.1016/s0065-230x(00)79004-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
MESH Headings
- Animals
- Cell Cycle Proteins/genetics
- Cell Cycle Proteins/physiology
- Chromosomes, Human, Pair 9/genetics
- Cricetinae
- Cyprinodontiformes
- Disease Progression
- Forecasting
- Genes, p16
- Genes, ras
- Growth Substances/physiology
- Humans
- Loss of Heterozygosity
- Melanocytes/metabolism
- Melanocytes/pathology
- Melanoma, Experimental/epidemiology
- Melanoma, Experimental/genetics
- Melanoma, Experimental/metabolism
- Melanoma, Experimental/pathology
- Mesocricetus
- Mice
- Mice, Transgenic
- Mutation
- Neoplasm Proteins/genetics
- Neoplasm Proteins/physiology
- Neoplasms, Radiation-Induced/epidemiology
- Neoplasms, Radiation-Induced/genetics
- Opossums
- Proteins/genetics
- Receptor Protein-Tyrosine Kinases/genetics
- Receptor Protein-Tyrosine Kinases/physiology
- Receptors, Growth Factor/genetics
- Receptors, Growth Factor/physiology
- Species Specificity
- Tumor Suppressor Protein p14ARF
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Affiliation(s)
- N Bardeesy
- Department of Adult Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
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Affiliation(s)
- L Chin
- Department of Dermatology, Harvard Medical School, Department of Adult Oncology, Dana-Farber Cancer Institute, 44 Binney Street, M413 Boston, Massachusetts, MA 02115, USA
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Bessou-Touya S, Morichon F, Surlève-Bazeille JE, Bioulac-Sage P, Pain C, Taïeb A. An ex vivo study of congenital pigmented nevi in epidermal reconstructs. PIGMENT CELL RESEARCH 1999; 12:164-74. [PMID: 10385912 DOI: 10.1111/j.1600-0749.1999.tb00509.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In order to study morphologic and functional characteristics of pigment cells in congenital pigmented nevi, autologous or heterologous reconstructs have been made using normal keratinocytes and nevus cells from the dermal-epidermal junction or from the dermis. All these cells, keratinocytes and nevus cells, were used as cell suspensions immediately after dissociation from the tissues or after subsequent brief cultivation in a serum-free medium. Reconstructed epidermis were cultured for 15 days at the air-liquid interface with or without ultraviolet (UV) B exposure. The reconstructs were examined macroscopically (formation of hyperpigmented macules), histologically (pigment cell nesting) and ultrastructurally (pigment structure and transfer). Typical nesting of nevus cells was observed in the dermal-epidermal junction or in the superficial dermis associated with macroscopically detectable small pigmented macules. UVB exposure induced an upward migration of nevus cells in the suprabasal layers of the epidermis. This tissue model can be considered as an excellent system for the ex vivo reproduction of pigmented nevi and as an assay of the sensitivity of nevus cells towards UVB irradiation.
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Affiliation(s)
- S Bessou-Touya
- Unité de Dermatologie, Laboratoire de Pathologie Moléculaire et Thérapie Génique, Université Victor Segalen, Bordeaux, France
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Sparrow LE, Heenan PJ. Differential expression of epidermal growth factor receptor in melanocytic tumours demonstrated by immunohistochemistry and mRNA in situ hybridization. Australas J Dermatol 1999; 40:19-24. [PMID: 10098284 DOI: 10.1046/j.1440-0960.1999.00310.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Differential expression of the epidermal growth factor receptor (EGFR) has been reported in melanocytic lesions. To evaluate these differences in EGFR expression in melanocytic tumours, formalin-fixed, paraffin embedded sections from 33 benign melanocytic neoplasms and 77 cutaneous melanomas were analysed for EGFR protein and mRNA expression using immunohistochemistry and mRNA in situ hybridization. The majority of benign and malignant lesions expressed EGFR at both protein and mRNA levels. In 7% (7/100) samples, mRNA but not protein expression was observed. Overall, a higher proportion of cells expressed EGFR protein in malignant lesions compared with benign lesions (P = 0.06), and the intensity of mRNA expression was higher in the malignant tumours (P < 0.001). No significant differences in EGFR protein or mRNA expression with tumour progression within the malignant lesions were seen. These results indicate that EGFR mRNA and protein expression is common to benign and malignant melanocytic lesions, and that an overall increase in expression is associated with malignant transformation. However, differential EGFR expression between in situ melanomas and invasive or metastatic lesions was not observed.
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Affiliation(s)
- L E Sparrow
- Medical Research Council Laboratory of Molecular Biology, Cambridge, United Kingdom.
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25
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Affiliation(s)
- L Chin
- Department of Dermatology, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02115 USA
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26
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Piérard GE, Piérard-Franchimont C, Nikkels A, Nikkels-Tassoudji N, Arrese JE, Bourguignon JP. Naevocyte triggering by recombinant human growth hormone. J Pathol 1996; 180:74-9. [PMID: 8943819 DOI: 10.1002/(sici)1096-9896(199609)180:1<74::aid-path595>3.0.co;2-a] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The influence of growth hormone and insulin-like growth factor I on human melanocytes is being increasingly recognized. Clinical evidence has shown that when recombinant human growth hormone (hGH) is administered to children of short stature, the growth of melanocytic naevi is boosted. This study was conducted on 56 hGH-triggered naevi and nine similar lesions excised before or after hGH therapy for hypopituitarism and Turner's syndrome. A series of 40 naevi excised from age-matched healthy children served as controls. Atypicality of naevocytes was investigated using image analysis, AgNOR counts, immunohistochemistry (HMB-45, NKI-C3, Ki-67, anti-bcl-2-oncoprotein), and DNA flow cytometry. The data associate hGH treatment with anisokaryosis and increased AgNOR and Ki-67 counts in naevocytes. The same cells also show abnormal patterns of HMB-45 immunolabelling. These indications of naevocyte activation were not suggestive of malignant transformation. hGH-triggered melanocytomas should be added to the list of atypical melanocytic naevi. The long-term evolution of these lesions remains unknown and the potential risk of malignant transformation awaits careful evaluation.
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Affiliation(s)
- G E Piérard
- Department of Dermatopathology and Pediatrics, University of Liège, Belgium
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27
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Hodak E, Gottlieb AB, Colen S, Anzilotti M, Krueger JG. In vivo expression of the insulin-like growth factor-I (IGF-I) receptor in congenital pigmented nevi. J Cutan Pathol 1996; 23:19-24. [PMID: 8720982 DOI: 10.1111/j.1600-0560.1996.tb00772.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Growth of normal melanocytes, nevus cells and primary melanoma cells is enhanced by insulin/insulin-like growth factor-I (IGF-I) in vitro. It has been shown that a melanoma cell line possesses the IGF-I receptor which plays a role in activation of the chemotactic response. Little is known about the in vivo expression of the IGF-I receptor and its role in melanocytic lesions. In an immunohistochemical study, we investigated the expression of IGF-I receptor in frozen sections of congenital pigmented nevi from 10 patients (ages 8 months to 4 yrs) using the monoclonal antibody alpha IR3, which specifically recognizes the extracellular alpha subunit of the IGF-I receptor. The proliferative activity of the nevus cells was examined by staining with Ki67 monoclonal antibody (reactive with all actively cycling cells). IGF-I receptor was found to be widely expressed by the cell surface of the nevus cells. Membrane staining was occasionally stronger in the superficial portion of the congenital pigmented nevi. In contrast, Ki67-positive cells were only sparsely scattered throughout the nevi with some tendency to localization to the superficial portion. This study indicates that in vivo the IGF-I receptor is widely expressed by congenital pigmented nevus cells. As opposed to keratinocytes, in which IGF-I receptor expression defines the proliferation pool of the normal and disordered epidermis, the IGF-I receptor is expressed by all nevus cells, irrespective of their proliferative status. Further studies are needed to assess whether the IGF-I receptor expression can serve as a marker for increased risk for development of malignancy in various types of benign melanocytic lesions.
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Affiliation(s)
- E Hodak
- Laboratory for Investigative Dermatology, Rockefeller University, New York, USA
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28
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Skender-Kalnenas TM, English DR, Heenan PJ. Benign melanocytic lesions: risk markers or precursors of cutaneous melanoma? J Am Acad Dermatol 1995; 33:1000-7. [PMID: 7490345 DOI: 10.1016/0190-9622(95)90294-5] [Citation(s) in RCA: 131] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND The role of benign melanocytic lesions as precursors and not only as risk markers for the development of cutaneous melanoma is controversial. OBJECTIVE The purpose of the study was to assess the frequency of the histologic association of benign melanocytic lesions with cutaneous melanoma of a maximum thickness of 1.00 mm. The possibility that the spatial association of benign lesions with melanoma may be coincidental was also investigated. METHODS The study subjects representing 289 cases of cutaneous melanoma of maximum thickness 1.00 mm (or less) were examined histologically for the presence of an associated benign melanocytic lesion(s), including lentiginous melanocytic proliferation; junctional, compound, or intradermal nevus; dysplastic nevus; and congenital nevus contiguous with or adjacent to the melanoma. The effects of age, tumor thickness, level of invasion, histologic type, and anatomic site on the association of benign melanocytic lesions with melanoma were assessed. In the control subjects 40 basal cell carcinomas and 38 compound nevi (not dysplastic) randomly chosen and matched for age (+/- 1 year) and site (head/neck, trunk, upper and lower limbs) with a melanoma case were examined to assess the proportion of these cases associated with benign lesions compared with the matched melanoma cases. RESULTS A nevus was associated with melanoma in 51% of cases (n = 147). Of these, 82 (56%) were dysplastic nevi, 61 (41%) were common acquired nevi, and 4 (3%) were congenital nevi. Lentiginous melanocytic proliferation was present in the epidermis adjacent to 219 melanomas (75%) and in 44% of these cases (n = 97) a coexisting nevus was also present. CONCLUSION The results of this study lend further support to the concept of common acquired nevi and dysplastic nevi as precursors of cutaneous melanoma. In addition, lesions diagnosed clinically as simple lentigo and solar lentigo may be important as potential precursors of melanoma, particularly in the elderly.
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Affiliation(s)
- T M Skender-Kalnenas
- Department of Dermatology, Sir Charles Gairdner Hospital, Nedlands, Western Australia
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29
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Nanney LB, Coffey RJ, Ellis DL. Expression and distribution of transforming growth factor-alpha within melanocytic lesions. J Invest Dermatol 1994; 103:707-14. [PMID: 7963661 DOI: 10.1111/1523-1747.ep12398575] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Stimulation of epidermal growth factor (EGF) receptor by ligands such as transforming growth factor (TGF) alpha may be associated with cell proliferation or transformation in both nevocytes and keratinocytes. Previously, EGF receptors have been identified within a variety of pigmented lesions, suggesting a possible responsiveness to ligands such as TGF alpha. In the present study, we characterize the intralesional expression and distribution of immunoreactive TGF alpha protein by avidin-biotin immunoperoxidase localization in benign nevi, congenital nevi, dysplastic nevi, and malignant melanomas. In situ hybridization techniques with TGF alpha riboprobes confirmed the constitutive production of TGF alpha in all types of pigmented lesions. The localization of TGF alpha expression to nevocytes when coupled with the previous reports of expression in basal keratinocytes suggests the possibility of either an autocrine mechanism of action for TGF alpha or a paracrine interplay of TGF alpha between keratinocytes and nevocytes within melanocytic lesions. An increase in immunoreactive TGF alpha in nevocytes was noted in both benign and dysplastic nevi from dysplastic nevus patients, as compared to benign nevi from normal patients. Congenital nevi and malignant melanomas showed an intermediate and variable level of TGF alpha immunoreactivity. When coupled with previous studies the data suggest linkage of the TGF alpha/EGF receptor pathway in the evolution of melanocytic lesions.
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Affiliation(s)
- L B Nanney
- Department of Plastic Surgery, Vanderbilt School of Medicine, Tennessee
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