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Jasper S, Keim U, Leiter U, Amaral T, Flatz L, Forschner A. Die Prognose des Melanoms im Kopf-Hals-Bereich im Stadium II hängt vom histologischen Subtyp ab. J Dtsch Dermatol Ges 2023; 21:1137-1147. [PMID: 37845056 DOI: 10.1111/ddg.15164_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 05/28/2023] [Indexed: 10/18/2023]
Abstract
ZusammenfassungHintergrund und ZieleDie Melanom‐Leitlinie basiert hauptsächlich auf dem AJCC‐Stadium. Hierbei wird nicht zwischen den histologischen Subtypen wie dem superfiziell spreitenden Melanom (SSM), dem Lentigo‐maligna‐Melanom (LMM) oder dem nodulären malignen Melanom (NM) unterschieden. Ziel der Studie war es zu untersuchen, ob sich Patienten mit LMM im klinischen Verlauf von Patienten mit SSM/NM unterscheiden. Dies ist aktuell besonders wichtig, da die adjuvante Anti‐PD‐1‐Therapie für Melanome im Stadium IIB und IIC zugelassen wurde.Patienten und MethodikDie Daten wurden aus dem Zentralregister „malignes Melanom“ entnommen. Es wurden nur Patienten mit LMM, SSM oder NM des Kopf‐Hals‐Bereichs und Primärdiagnose zwischen dem 01.01.2000 und dem 31.12.2019 eingeschlossen. Das progressionsfreie Überleben (PFÜ), das melanomspezifische Überleben (MSÜ) und das Metastasierungsmuster wurden für die Gruppe der LMM im Vergleich zur Gruppe der SSM/NM analysiert.ErgebnisseDie LMM‐Kohorte (n = 902) hatte ein signifikant besseres MSÜ als die SSM/NM‐Kohorte (n = 604). Beim PFÜ gab es keinen Unterschied. Das 5‐Jahres‐MSÜ der LMM‐Kohorte im Stadium II betrug 88,5 % (95 % KI 81,4–95,6), im Vergleich dazu das der SSM/NM‐Kohorte im Stadium II 79,7 % (95 % KI 72,8–86,6).SchlussfolgerungEs scheint nicht angebracht zu sein, eine adjuvante Therapie bei LMM‐Patienten im Stadium II im gleichen Umfang durchzuführen, wie bei Patienten mit SSM/NM.
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Affiliation(s)
- Sophie Jasper
- Abteilung für Dermatologie, Zentrum für Dermatoonkologie, Universitätsklinikum Tübingen
| | - Ulrike Keim
- Abteilung für Dermatologie, Zentrum für Dermatoonkologie, Universitätsklinikum Tübingen
| | - Ulrike Leiter
- Abteilung für Dermatologie, Zentrum für Dermatoonkologie, Universitätsklinikum Tübingen
| | - Teresa Amaral
- Abteilung für Dermatologie, Zentrum für Dermatoonkologie, Universitätsklinikum Tübingen
| | - Lukas Flatz
- Abteilung für Dermatologie, Zentrum für Dermatoonkologie, Universitätsklinikum Tübingen
| | - Andrea Forschner
- Abteilung für Dermatologie, Zentrum für Dermatoonkologie, Universitätsklinikum Tübingen
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Jasper S, Keim U, Leiter U, Amaral T, Flatz L, Forschner A. Prognosis in stage II melanoma of the head and neck depends on the histological subtype. J Dtsch Dermatol Ges 2023; 21:1137-1146. [PMID: 37485634 DOI: 10.1111/ddg.15164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 05/28/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND AND OBJECTIVES The melanoma guideline is mainly based on the AJCC stage. There is no difference according to histological subtypes such as superficial spreading melanoma (SSM), lentigo maligna melanoma (LMM) or nodular malignant melanoma (NM). We aimed to evaluate whether patients with LMM have a different clinical course from patients with SSM/NM. This is particularly important as adjuvant anti-PD-1 therapy is approved for stage IIB and IIC melanoma. PATIENTS AND METHODS Data were extracted from the Central Registry of Malignant Melanoma. Only patients with LMM, SSM, and NM of the head and neck with primary diagnosis between 01/01/2000 and 12/31/2019 were included. Progression-free survival (PFS), melanoma-specific survival (MSS), and pattern of metastases were analyzed for the LMM group compared to SSM/NM. RESULTS The LMM cohort (n = 902) had significantly better MSS than the SSM/NM cohort (n = 604). There was no difference in PFS. The 5-year MSS of the stage II LMM cohort was 88.5% (95% CI 81.4-95.6) compared to 79.7% (95% CI 72.8-86.6) in the stage II SSM/NM cohort. CONCLUSION It does not appear appropriate to use adjuvant therapy in stage II LMM patients to the same extent as in patients with SSM/NM.
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Affiliation(s)
- Sophie Jasper
- Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, Tübingen, Germany
| | - Ulrike Keim
- Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, Tübingen, Germany
| | - Ulrike Leiter
- Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, Tübingen, Germany
| | - Teresa Amaral
- Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, Tübingen, Germany
| | - Lukas Flatz
- Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, Tübingen, Germany
| | - Andrea Forschner
- Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, Tübingen, Germany
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Safety of combining dabrafenib plus trametinib in elderly BRAF V600 mutation-positive advanced melanoma patients: real-world data analysis of Spanish patients (ELDERLYMEL). Melanoma Res 2022; 32:343-352. [PMID: 35762583 DOI: 10.1097/cmr.0000000000000837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Efficacy and safety of dabrafenib and trametinib in metastatic melanoma have been demonstrated in two-phase III and one-phase I/II clinical trials. However, patients at least 75 years old (y.o.) were largely underrepresented. Additionally, the safety profile of dabrafenib and trametinib based on age is unknown. ELDERLYMEL is a retrospective noninterventional multicenter study, describing the effectiveness and safety of at least 75 y.o. patients compared with less than 75 y.o. patients with advanced BRAF V600-mutated melanoma treated with dabrafenib plus trametinib or dabrafenib monotherapy. A total of 159 patients were included, 130 less than 75 y.o. and 29 at least 75 y.o. Clinical features were similar between the groups, except in the number of comorbidities, number of metastatic sites, Eastern Cooperative Oncology Group (ECOG) performance status, and BRAF V600-mutation type. Five patients per group received dabrafenib monotherapy. There were no differences in adverse events (AEs) rate or grade between the groups. However, AE profiles were different between the groups, being pyrexia infrequent in patients at least 75 y.o. (13.8% vs. 42.3%; P = 0.005). Dabrafenib and trametinib dose intensities were lower in at least 75 y.o. patients (P = 0.018 and P = 0.020), but there were no differences in effectiveness between the groups. Finally, in a multivariate analysis, sex (female) was the only variable independently associated with an increased risk of AE grade ≥3. Data from the ELDERLYMEL study demonstrate that dabrafenib plus trametinib is safe and effective in at least 75 y.o. patients with advanced BRAF V600-mutated melanoma without increasing toxicity. Additionally, we describe a different safety profile depending on age and sex.
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Rinonce HT, Sastri DJ, Trisnawati F, Kameswari B, Ferronika P, Irianiwati. The frequency and clinicopathological significance of NRAS mutations in primary cutaneous nodular melanoma in Indonesia. Cancer Rep (Hoboken) 2022; 5:e1454. [PMID: 34110110 PMCID: PMC8789608 DOI: 10.1002/cnr2.1454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Melanoma is a lethal skin malignancy with a high risk of metastasis, which prompts a need for research on treatment targets and prognostic factors. Recent studies show that the presence of neuroblastoma RAS viral oncogene homolog (NRAS) mutation can influence cell growth in melanomas. The NRAS mutation, which stimulates the mitogen-activated protein kinase (MAPK) signaling pathway, is associated with a lower survival rate. However, evidence from Indonesia population is still very rare. Further understanding of the role of NRAS mutations in Indonesian melanoma cases will be crucial in developing new management strategies for melanoma patients with NRAS mutations. AIMS To explore the frequency of NRAS mutations and their clinicopathological associations in patients with primary nodular cutaneous melanoma in Central Java and Yogyakarta, Indonesia. METHODS AND RESULTS Fifty-one paraffin-embedded tissue samples were collected from primary nodular skin melanoma cases between 2011 and 2019 from the two largest referral hospitals in Yogyakarta and Central Java, Indonesia. The NRAS mutation status was evaluated using qualitative real-time polymerase chain reaction (qRT-PCR). The association of NRAS mutation was analyzed with the following: age, gender, location, lymph node metastasis, ulceration, mitotic index, tumor-infiltrating lymphocytes (TILs), necrosis, tumor thickness, lymphovascular invasion (LVI), and tumor size. NRAS mutations were detected in 10 (19.6%) samples and predominantly observed (60%) in exon 2 (G12). These mutations were significantly correlated with lymph node metastases (p = .000); however, they were not associated with other variables analyzed in this study. CONCLUSIONS The prevalence of NRAS mutations in primary nodular cutaneous melanoma cases from Indonesia is consistent with previous studies and is significantly associated with increased lymph node metastases. However, the predominant mutation detected in exon 2 (G12) is different from previous studies conducted in other countries. This suggests that melanoma cases in Javanese people have different characteristics from other ethnicities.
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Affiliation(s)
- Hanggoro Tri Rinonce
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and NursingUniversitas Gadjah Mada/ Dr. Sardjito HospitalSlemanYogyakartaIndonesia
| | - Deflen Jumatul Sastri
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and NursingUniversitas Gadjah Mada/ Dr. Sardjito HospitalSlemanYogyakartaIndonesia
| | - Fita Trisnawati
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and NursingUniversitas Gadjah Mada/ Dr. Sardjito HospitalSlemanYogyakartaIndonesia
| | - Bidari Kameswari
- Department of Anatomical Pathologydr. Soeradji Tirtonegoro HospitalKlatenCentral JavaIndonesia
| | - Paranita Ferronika
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and NursingUniversitas Gadjah Mada/ Dr. Sardjito HospitalSlemanYogyakartaIndonesia
| | - Irianiwati
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and NursingUniversitas Gadjah Mada/ Dr. Sardjito HospitalSlemanYogyakartaIndonesia
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Prognostic factors and population-based analysis of melanoma with sentinel lymph node biopsy. Sci Rep 2021; 11:20524. [PMID: 34654890 PMCID: PMC8521595 DOI: 10.1038/s41598-021-99950-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/30/2021] [Indexed: 01/08/2023] Open
Abstract
Cutaneous malignant melanoma is a rare but fatal disease in East Asia. Despite its increasing incidence, a general lack of awareness about the disease was noted. This study aims to provide population-based prognostic analysis of melanoma with sentinel lymph node biopsy (SLNB) in Taiwan. We conducted this retrospective cohort study using the data from Taiwan National Health Insurance Research Database during 1997–2013. The study cohort contains 3284 patients. The 5-year survival rates of patients undergoing SLNB and not undergoing SLNB were 45.5% and 33.6%. In multivariate analysis, age ≥ 80 years [adjusted hazard ratio (aHR) = 2.15] and male (aHR = 1.19) were associated with a poorer prognosis, while high social economic status (SES) (aHR = 0.69) and undergoing SLNB (aHR = 0.84) were good prognostic factors. Old age and low SES were associated with lower percentages of patients undergoing SLNB (P < 0.001). E-value analysis suggested robustness to unmeasured confounding. In conclusion, undergoing SLNB was associated with a better prognosis. The poor prognosis of old age and low SES may be due to decreased percentages of patients undergoing SLNB. Therefore, we recommend that SLNB should be performed on patients, especially in old age or low SES, who are candidates for SLNB according to current guidelines to achieve maximal survival.
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Loria D, Abriata MG, Santoro F, Latorre C. Cutaneous melanoma in Argentina: an analysis of its characteristics and regional differences. Ecancermedicalscience 2020; 14:1017. [PMID: 32256700 PMCID: PMC7105344 DOI: 10.3332/ecancer.2020.1017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Indexed: 12/11/2022] Open
Abstract
Purpose This study aims to increase the knowledge about the characteristics of cutaneous melanoma in Argentina, their association with the risk of having Breslow ≥1 mm and mortality trends for the period 2002-2017. Patients and methods Descriptive statistics and regression analyses were done for 10.199 cases within the Argentine Melanoma Registry in the period 2002-2018. Trends in age-standardised mortality rates (ASMR) were analysed using the Join point Regression Model. Results Cases showed lesions mainly located in males' trunk (37%) and in females' lower limbs (29%). The level of invasion was higher in males who also showed higher mortality. Cases from the North West and North East regions showed a major risk of Breslow >1 mm and harboured CM in lower limbs more frequently than in other regions. Nearly, 25% of tumours over 2 mm were in cases aged <50 years and 37.6% in patients ≥50 years. In the North West, North East and Patagonia, the frequency of cases in young people was higher than in older people. In 43% of cases, the melanoma subtype was not specified in the report. The number of superficial spreading melanomas, the most common histology, was nearly twice that of Nodular melanomas the following histology in importance (3,403 and 1,754, respectively). Melanoma mortality rates in all Argentine population increased in the elderly. Lower melanoma mortality rates were observed in the North West. In 2007-2017, ASMR decreased significantly in females (average 1.4% p/year) while it increased nonsignificantly in males (0.4% p/year).The tumours with the worst prognosis were associated with the elderly, males, nodular or acrolentiginous morphologies, residing somewhere other than Centro and Patagonia and with tumors located in the head/neck and legs. Conclusion The geographical variations found for melanoma characteristics and their mortality in Argentina, makes it imperative that epidemiological research is continued to avoid generalisations and improve future preventive actions.
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Affiliation(s)
- Dora Loria
- Argentine Registry of Cutaneous Melanoma, Av Callao 852, C1025 CABA, Argentina
| | | | - Federico Santoro
- Fellow of Epidemiology, National Ministry of Health, Av 9 de Julio 1925, C1072 CABA, Argentina
| | - Clara Latorre
- Argentine Registry of Cutaneous Melanoma, Av Callao 852, C1025 CABA, Argentina
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Lugassy C, Kleinman HK, Vermeulen PB, Barnhill RL. Angiotropism, pericytic mimicry and extravascular migratory metastasis: an embryogenesis-derived program of tumor spread. Angiogenesis 2019; 23:27-41. [PMID: 31720876 DOI: 10.1007/s10456-019-09695-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 10/29/2019] [Indexed: 02/07/2023]
Abstract
Intravascular dissemination of tumor cells is the accepted mechanism of cancer metastasis. However, the phenomenon of angiotropism, pericyte mimicry (PM), and extravascular migratory metastasis (EVMM) has questioned the concept that tumor cells metastasize exclusively via circulation within vascular channels. This new paradigm of cancer spread and metastasis suggests that metastatic cells employ embryonic mechanisms for attachment to the abluminal surfaces of blood vessels (angiotropism) and spread via continuous migration, competing with and replacing pericytes, i.e., pericyte mimicry (PM). This is an entirely extravascular phenomenon (i.e., extravascular migratory metastasis or EVMM) without entry (intravasation) into vascular channels. PM and EVMM have mainly been studied in melanoma but also occur in other cancer types. PM and EVMM appear to be a reversion to an embryogenesis-derived program. There are many analogies between embryogenesis and cancer progression, including the important role of laminins, epithelial-mesenchymal transition, and the re-activation of embryonic signals by cancer cells. Furthermore, there is no circulation of blood during the first trimester of embryogenesis, despite the fact that there is extensive migration of cells to distant sites and formation of organs and tissues during this period. Embryonic migration therefore is a continuous extravascular migration as are PM and EVMM, supporting the concept that these embryonic migratory events appear to recur abnormally during the metastatic process. Finally, the perivascular location of tumor cells intrinsically links PM to vascular co-option. Taken together, these two new paradigms may greatly influence the development of new effective therapeutics for metastasis. In particular, targeting embryonic factors linked to migration that are detected during cancer metastasis may be particularly relevant to PM/EVMM.
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Affiliation(s)
- Claire Lugassy
- Department of Translational Research, Institut Curie, Paris, France.
| | - Hynda K Kleinman
- Department of Molecular Medicine and Biochemistry, The George Washington School of Medicine, Washington, DC, USA
| | - Peter B Vermeulen
- Translational Cancer Research Unit, GZA Hospitals, Sint-Augustinus, Antwerp, Belgium.,Center for Oncological Research (CORE, Faculty of Medicine and Health Sciences), University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Raymond L Barnhill
- Department of Translational Research, Institut Curie, Paris, France.,University of Paris, Réné Descartes Faculty of Medicine, Paris, France
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Cizkova J, Sinkorova Z, Strnadova K, Cervinkova M, Horak V, Sinkora J, Stepanova K, Sinkora M. The role of αβ T-cells in spontaneous regression of melanoma tumors in swine. DEVELOPMENTAL AND COMPARATIVE IMMUNOLOGY 2019; 92:60-68. [PMID: 30308209 DOI: 10.1016/j.dci.2018.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/05/2018] [Accepted: 10/05/2018] [Indexed: 06/08/2023]
Abstract
Using a porcine model, we describe Melanoma-Associated CD4+CD8hi T-lymphocytes (MATL) in peripheral blood that increase during melanoma regression. These MATL possess the CD4+CD8hi phenotype and they have their direct counterparts in Tumor Infiltrating Lymphocytes (TIL) isolated from melanoma loci. Both MATL and CD4+CD8hi TIL have a similar expression of selected markers indicating that they represent effector/memory αβ T-cell subset. Moreover, although TIL also contain CD4-CD8+ T-cells, only CD4+CD8hi TIL expand during melanoma regression. Importantly, TIL isolated from different pigs and different melanoma loci among the same pig have similar composition of CD4/CD8 subsets, indicating that the composition of the MATL and TIL compartment is identical. Analysis of sorted cells from regressing pigs revealed a unique MATL subpopulation with mono-specific T-cell receptor that was further analyzed by sequencing. These results indicate that pigs regressing melanomas possess a characteristic population of recirculating T-cells playing a role in tumor control and regression.
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Affiliation(s)
- Jana Cizkova
- Laboratory of Applied Proteome Analyses, Institute of Animal Physiology and Genetics of the Czech Academy of Sciences, Libechov, Czech Republic; Laboratory of Tumor Biology, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Libechov, Czech Republic; Department of Veterinary Sciences, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences, Prague, Czech Republic
| | - Zuzana Sinkorova
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic.
| | - Kristyna Strnadova
- Laboratory of Applied Proteome Analyses, Institute of Animal Physiology and Genetics of the Czech Academy of Sciences, Libechov, Czech Republic; Laboratory of Tumor Biology, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Libechov, Czech Republic; Department of Veterinary Sciences, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences, Prague, Czech Republic
| | - Monika Cervinkova
- Laboratory of Tumor Biology, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Libechov, Czech Republic; Surgical Department, 1st Medical Faculty of Charles University and Hospital Na Bulovce, Prague, Czech Republic
| | - Vratislav Horak
- Laboratory of Applied Proteome Analyses, Institute of Animal Physiology and Genetics of the Czech Academy of Sciences, Libechov, Czech Republic; Laboratory of Tumor Biology, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Libechov, Czech Republic
| | - Jiri Sinkora
- Life Sciences, Becton Dickinson Czechia, s.r.o., Prague, Czech Republic
| | - Katerina Stepanova
- Laboratory of Gnotobiology, Institute of Microbiology of the Czech Academy of Sciences, Novy Hradek, Czech Republic
| | - Marek Sinkora
- Laboratory of Gnotobiology, Institute of Microbiology of the Czech Academy of Sciences, Novy Hradek, Czech Republic.
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Correlation with lymphocyte infiltration, but lack of prognostic significance of MECA-79-positive high endothelial venules in primary malignant melanoma. Melanoma Res 2019; 28:304-310. [PMID: 29683859 DOI: 10.1097/cmr.0000000000000457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
High endothelial venules (HEVs) are specialized vessels in lymphoid organs, supporting lymphocyte trafficking from the blood. As the presence of these vessels was described recently in tumors, it was proposed that they could facilitate the development of antitumor immune response, resulting in improved prognosis. The aim of our study was to analyze the correlation of the density of HEVs with that of the different immune cell types as well as with the clinicopathologic parameters and the disease outcomes in patients with cutaneous melanoma. Primary melanoma samples of 118 patients were analyzed retrospectively by immunohistochemical labeling and quantitation of vessels stained with the MECA-79 antibody, as well as a panel of eight different immune cell types (CD8 and CD45RO T cells, lymphocytes expressing the CD25, CD134, or CD137 activation markers, FOXP3 regulatory T cells, CD20 B cells, and DC-LAMP mature dendritic cells). Correlations of MECA-79 vessel density with that of the immune cells, as well as with clinicopathologic parameters and disease outcomes were evaluated. We showed that the number of MECA-79 vessels correlates strongly with the peritumoral density of B and T lymphocytes. Moreover, higher HEV numbers were detected in tumors hosting tertiary lymphoid structures as well as in those of axial location compared with the ones in the extremity and in men compared with women, whereas no association was found with patient age, tumor thickness, histologic type or ulceration, or with the survival of melanoma patients. The density of MECA-79 HEVs in primary melanomas shows a correlation with B and T-lymphocyte density and differences according to the presence of tertiary lymphoid structures, tumor site, and the sex of the patient. However, it has no prognostic value.
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Curchin DJ, Harris VR, McCormack CJ, Smith SD. Changing trends in the incidence of invasive melanoma in Victoria, 1985-2015. Med J Aust 2018; 208:265-269. [PMID: 29614940 DOI: 10.5694/mja17.00725] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 01/19/2018] [Indexed: 12/17/2023]
Affiliation(s)
| | | | | | - Saxon D Smith
- Northern Clinical School, University of Sydney, Sydney, NSW
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11
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A prognostic model for resectable acral melanoma patients on the basis of preoperative inflammatory markers. Melanoma Res 2017; 27:469-476. [DOI: 10.1097/cmr.0000000000000365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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12
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Spontaneous regression of malignant melanoma - is it based on the interplay between host immune system and melanoma antigens? Anticancer Drugs 2017; 28:819-830. [DOI: 10.1097/cad.0000000000000526] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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13
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Nagarajan P, Curry JL, Ning J, Piao J, Torres-Cabala CA, Aung PP, Ivan D, Ross MI, Levenback CF, Frumovitz M, Gershenwald JE, Davies MA, Malpica A, Prieto VG, Tetzlaff MT. Tumor Thickness and Mitotic Rate Robustly Predict Melanoma-Specific Survival in Patients with Primary Vulvar Melanoma: A Retrospective Review of 100 Cases. Clin Cancer Res 2016; 23:2093-2104. [PMID: 27864417 DOI: 10.1158/1078-0432.ccr-16-2126] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/27/2016] [Accepted: 11/11/2016] [Indexed: 11/16/2022]
Abstract
Purpose: Primary vulvar melanoma (PVM) is the second most common vulvar malignancy. Despite their distinct anatomic site and unique molecular-genetic alterations, PVMs are staged according to the American Joint Committee on Cancer (AJCC) guidelines for primary cutaneous melanomas (PCM). However, whether parameters derived for PCM also apply to PVM remain a critical yet largely unexplored clinical question. The objective of this study was to determine the parameters predictive of survival in PVM.Experimental Design: We retrospectively reviewed 100 patients with PVM and determined associations between clinical and histopathologic parameters and disease-specific survival (DSS) and overall survival (OS).Results: Univariate Cox regression analysis demonstrated older age (>56 years), greater tumor thickness, higher dermal mitotic rate, ulceration, lymphovascular invasion, perineural invasion, microscopic satellitosis, and absence of precursor nevus associated with decreased OS. Furthermore, age, midline, and/or multifocal involvement, greater tumor thickness, higher dermal mitotic rate, ulceration, lack of regression, lymphovascular invasion, perineural invasion, and microscopic satellitosis associated with decreased DSS. Multivariate analysis demonstrated tumor thickness, dermal mitotic rate, lymphovascular invasion, microscopic satellitosis, and absence of precursor nevus independently predicted shorter OS. Only tumor thickness and increased dermal mitotic rate (≥2/mm2) independently predicted reduced DSS. In comparison with the AJCC T-category, a novel, bivariate T-category based only on tumor thickness and dermal mitotic rate robustly predicted OS and DSS in our patient cohort.Conclusions: In the largest single institutional study of PVM, we demonstrate a combination of tumor thickness and mitotic rate comprise a simple but robust T-category to direct staging and prognosis. Clin Cancer Res; 23(8); 2093-104. ©2016 AACR.
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Affiliation(s)
| | - Jonathan L Curry
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jing Ning
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jin Piao
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Carlos A Torres-Cabala
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Phyu P Aung
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Doina Ivan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Merrick I Ross
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Charles F Levenback
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael Frumovitz
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael A Davies
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Anais Malpica
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Victor G Prieto
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael T Tetzlaff
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas. .,Department of Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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14
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Naouali C, Jones M, Nabouli I, Jerbi M, Tounsi H, Ben Rekaya M, Ben Ahmed M, Bouhaouala B, Messaoud O, Khaled A, Zghal M, Abdelhak S, Boubaker S, Yacoub-Youssef H. Epidemiological trends and clinicopathological features of cutaneous melanoma in sporadic and xeroderma pigmentosum Tunisian patients. Int J Dermatol 2016; 56:40-48. [DOI: 10.1111/ijd.13448] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 06/29/2016] [Accepted: 07/22/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Chokri Naouali
- LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique; Université Tunis El Manar; Institut Pasteur de Tunis; Tunis Tunisia
| | - Meriem Jones
- Service de dermatologie; hôpital Charles Nicolle; Tunis Tunisia
| | - Imen Nabouli
- LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique; Université Tunis El Manar; Institut Pasteur de Tunis; Tunis Tunisia
| | - Manel Jerbi
- LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique; Université Tunis El Manar; Institut Pasteur de Tunis; Tunis Tunisia
| | - Haifa Tounsi
- LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique; Université Tunis El Manar; Institut Pasteur de Tunis; Tunis Tunisia
| | - Mariem Ben Rekaya
- LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique; Université Tunis El Manar; Institut Pasteur de Tunis; Tunis Tunisia
| | - Melika Ben Ahmed
- LR11IPT02 Laboratoire de Transmission, Contrôle et Immunobiologie des Infections; Université de Tunis El Manar; Institut Pasteur de Tunis; Tunis Tunisia
| | - Balkiss Bouhaouala
- LR11IPT08 Laboratoire Venins et Biomolécules Thérapeutiques; Université de Tunis El Manar; Institut Pasteur de Tunis; Tunis Tunisia
| | - Olfa Messaoud
- LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique; Université Tunis El Manar; Institut Pasteur de Tunis; Tunis Tunisia
| | - Aida Khaled
- Service de dermatologie; hôpital Charles Nicolle; Tunis Tunisia
| | - Mohamed Zghal
- Service de dermatologie; hôpital Charles Nicolle; Tunis Tunisia
| | - Sonia Abdelhak
- LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique; Université Tunis El Manar; Institut Pasteur de Tunis; Tunis Tunisia
| | - Samir Boubaker
- LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique; Université Tunis El Manar; Institut Pasteur de Tunis; Tunis Tunisia
| | - Houda Yacoub-Youssef
- LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique; Université Tunis El Manar; Institut Pasteur de Tunis; Tunis Tunisia
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15
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Tweedy L, Susanto O, Insall RH. Self-generated chemotactic gradients-cells steering themselves. Curr Opin Cell Biol 2016; 42:46-51. [PMID: 27105308 DOI: 10.1016/j.ceb.2016.04.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 04/04/2016] [Indexed: 01/26/2023]
Abstract
Chemotaxis is a fundamentally important part of biology, but we know very little about how gradients of chemoattractant are formed. One answer is self-generated gradients, in which the moving cells break down the attractant to provide their own gradient as they migrate. Here we discuss where self-generated gradients are known, how they can be recognized, and where they are likely to be found in the future.
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Affiliation(s)
- Luke Tweedy
- Cancer Research UK Beatson Institute, Switchback Road, Bearsden G61 1BD, UK
| | - Olivia Susanto
- Cancer Research UK Beatson Institute, Switchback Road, Bearsden G61 1BD, UK
| | - Robert H Insall
- Cancer Research UK Beatson Institute, Switchback Road, Bearsden G61 1BD, UK.
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16
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Shimizu A, Kaira K, Yasuda M, Asao T, Ishikawa O. Clinical and Pathological Significance of ER Stress Marker (BiP/GRP78 and PERK) Expression in Malignant Melanoma. Pathol Oncol Res 2016; 23:111-116. [PMID: 27502501 DOI: 10.1007/s12253-016-0099-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 07/31/2016] [Indexed: 01/19/2023]
Abstract
Glucose-regulated protein of 78 kD (GRP78) also referred to as immunoglobulin heavy chain binding protein (BiP/GRP78) plays an important role in the endoplasmic reticulum (ER) stress. The level of BiP/GRP78 is highly elevated in various human cancers. The purpose of this study is to examine the prognostic significance of BiP/GRP78 expression in patients with malignant melanoma. A total of 133 malignant melanoma patients were analyzed, and tumor specimens were stained by immunohistochemistry for BiP/GRP78, PKR-like endoplasmic reticulum kinase (PERK), Ki-67, p53 and microvessel density (MVD) determined by CD34. BiP/GRP78 and PERK were highly expressed in 40 % (53/133) and 78 % (104/133), respectively. BiP/GRP78 disclosed a significant relationship with PERK expression, thickness, T factor, N factor, disease staging, cell proliferation (Ki-67) and MVD (CD34). By multivariate analysis, the high expression of BiP/GRP78 was identified as an independent prognostic factor for predicting poor survival against malignant melanoma. The increased BiP/GRP78 expression was clarified as an independent prognostic marker for predicting worse outcome. ER stress marker, BiP/GRP78 could be a powerful molecular target for the treatment of malignant melanoma.
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Affiliation(s)
- Akira Shimizu
- Department of Dermatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
| | - Kyoichi Kaira
- Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Masahito Yasuda
- Department of Dermatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Takayuki Asao
- Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Osamu Ishikawa
- Department of Dermatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
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17
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Muinonen-Martin AJ, Insall RH. Melanomas' fatal attraction to lysophosphatidic acid trails: a new prognostic and therapeutic approach? Melanoma Manag 2015; 2:97-100. [PMID: 30190836 PMCID: PMC6094656 DOI: 10.2217/mmt.15.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Andrew J Muinonen-Martin
- Leeds Cancer Centre, Bexley Wing, St James’ University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
| | - Robert H Insall
- CRUK Beatson Institute for Cancer Research, Glasgow, G61 1BD, UK
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18
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Muinonen-Martin AJ, Susanto O, Zhang Q, Smethurst E, Faller WJ, Veltman DM, Kalna G, Lindsay C, Bennett DC, Sansom OJ, Herd R, Jones R, Machesky LM, Wakelam MJO, Knecht DA, Insall RH. Melanoma cells break down LPA to establish local gradients that drive chemotactic dispersal. PLoS Biol 2014; 12:e1001966. [PMID: 25313567 PMCID: PMC4196730 DOI: 10.1371/journal.pbio.1001966] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 09/05/2014] [Indexed: 12/21/2022] Open
Abstract
The high mortality of melanoma is caused by rapid spread of cancer cells, which occurs unusually early in tumour evolution. Unlike most solid tumours, thickness rather than cytological markers or differentiation is the best guide to metastatic potential. Multiple stimuli that drive melanoma cell migration have been described, but it is not clear which are responsible for invasion, nor if chemotactic gradients exist in real tumours. In a chamber-based assay for melanoma dispersal, we find that cells migrate efficiently away from one another, even in initially homogeneous medium. This dispersal is driven by positive chemotaxis rather than chemorepulsion or contact inhibition. The principal chemoattractant, unexpectedly active across all tumour stages, is the lipid agonist lysophosphatidic acid (LPA) acting through the LPA receptor LPAR1. LPA induces chemotaxis of remarkable accuracy, and is both necessary and sufficient for chemotaxis and invasion in 2-D and 3-D assays. Growth factors, often described as tumour attractants, cause negligible chemotaxis themselves, but potentiate chemotaxis to LPA. Cells rapidly break down LPA present at substantial levels in culture medium and normal skin to generate outward-facing gradients. We measure LPA gradients across the margins of melanomas in vivo, confirming the physiological importance of our results. We conclude that LPA chemotaxis provides a strong drive for melanoma cells to invade outwards. Cells create their own gradients by acting as a sink, breaking down locally present LPA, and thus forming a gradient that is low in the tumour and high in the surrounding areas. The key step is not acquisition of sensitivity to the chemoattractant, but rather the tumour growing to break down enough LPA to form a gradient. Thus the stimulus that drives cell dispersal is not the presence of LPA itself, but the self-generated, outward-directed gradient.
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Affiliation(s)
- Andrew J. Muinonen-Martin
- CRUK Beatson Institute, Glasgow, United Kingdom
- York Teaching Hospital NHS Foundation Trust, York, United Kingdom
- The Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | | | - Qifeng Zhang
- The Babraham Institute, Cambridge, United Kingdom
| | | | | | | | | | - Colin Lindsay
- CRUK Beatson Institute, Glasgow, United Kingdom
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Dorothy C. Bennett
- Molecular Cell Sciences Research Centre, St. George's, University of London, London, United Kingdom
| | | | - Robert Herd
- Alan Lyell Centre for Dermatology, Glasgow, United Kingdom
| | - Robert Jones
- CRUK Beatson Institute, Glasgow, United Kingdom
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | | | | | - David A. Knecht
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, Connecticut, United States of America
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19
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Immunolabeling for p16, WT1, and Fli-1 in the assignment of growth phase for cutaneous melanomas. Am J Dermatopathol 2014; 36:718-22. [PMID: 25062258 DOI: 10.1097/dad.0000000000000066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Distinction between radial growth phase (RGP) and vertical growth phase (VGP) in cutaneous melanomas is prognostically significant. Despite established morphological criteria, molecular markers to separate RGP and VGP have not been well established. The goal of this study was to investigate associations of p16, WT1, and Fli-1 with RGP-to-VGP progression, by immunohistochemistry. The p16 is a tumor suppressor, whereas WT1 and Fli-1 are transcriptional activators. The authors hypothesized that entry into VGP would be associated with decreased p16 and increased WT1 and Fli-1. Paraffin sections from 18 RGP and 15 VGP melanomas were immunostained with well-characterized antibodies to p16, WT1, and Fli-1. Melanoma growth phases were determined using precodified morphological attributes. In RGP melanomas, p16 was expressed in 15 of 18 (83%), WT1 in 17 of 17 (100%), and Fli-1 at least focally in 6 of 18 (33%). The deep dermal component of VGP melanomas stained positively for Fli-1 in 9 of 14 (64%), strongly for WT1 in 10 of 14 (71%), and strongly for p16 in only 2 of 15 (13%). Observed patterns of WT1 immunopositivity did not support the authors' hypothesis; it is not likely to be a good indicator of VGP. On the other hand, Fli-1 staining trended toward more positive deep tumor compartment staining and p16 to weaker staining in the deep compartment. At present, application of histological criteria remains the best method for assignment of growth phase in melanomas; however, p16 and possibly Fli-1 immunostains may serve as useful adjuncts in morphologically indeterminate cases.
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20
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Vilanova CMA, Lages RB, Ribeiro SM, Almeida IP, Santos LGD, Vieira SC. Epidemiological and histopathological profile of cutaneous melanoma at a center in northeastern Brazil from 2000 to 2010. An Bras Dermatol 2014; 88:545-53. [PMID: 24068125 PMCID: PMC3760929 DOI: 10.1590/abd1806-4841.20132036] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 10/14/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND While representing only 3-4% of malignant skin tumors, cutaneous melanoma is the
most aggressive and lethal. Statistical knowledge about the biological behavior of
this tumor is essential for guiding daily outpatient practice and aiding public
health policies. OBJECTIVES To analyze the profile of patients with cutaneous melanoma attending a pathology
department in Teresina (state of Piauí) between 2000 and 2010. METHODS Retrospective study of melanoma patients diagnosed between 2000 and 2010 in the
São Marcos Hospital in the city of Teresina. The pathology laboratory reports were
studied and all the statistical analyses performed using SPSS 19.0. RESULTS A total of 25 in situ, 199 invasive and 89 metastatic melanomas of unknown
primary site were observed. Histological types found were nodular (52.8%),
superficial spreading melanoma (18.6%), acral (10.6%) and lentigo maligna (9.5%).
In 144 (73.4%) cases the Breslow thickness was >1 mm. Metastasis was found in
28.6% of invasive melanomas and nodular melanoma, Clark IV/ V, Breslow > 1 mm,
mitotic index ≥ 6 and ulcerated lesions were more likely to metastasize. CONCLUSION Most melanomas presented Breslow> 1mm. The main factors associated with
metastasis were nodular type, Clark IV / V, Breslow> 1mm, mitotic index ≥ 6
and ulcerated lesions.
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21
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Lugassy C, Barnhill RL. Angiotropism and extravascular migratory metastasis in melanoma: from concept to gene expression. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.11.24] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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22
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Lee N, Barthel SR, Schatton T. Melanoma stem cells and metastasis: mimicking hematopoietic cell trafficking? J Transl Med 2014; 94:13-30. [PMID: 24126889 PMCID: PMC3941309 DOI: 10.1038/labinvest.2013.116] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 09/04/2013] [Accepted: 09/08/2013] [Indexed: 12/16/2022] Open
Abstract
Malignant melanoma is a highly metastatic cancer that bears responsibility for the majority of skin cancer-related deaths. Amidst the research efforts to better understand melanoma progression, there has been increasing evidence that hints at a role for a subpopulation of virulent cancer cells, termed malignant melanoma stem or initiating cells (MMICs), in metastasis formation. MMICs are characterized by their preferential ability to initiate and propagate tumor growth and their selective capacity for self-renewal and differentiation into less tumorigenic melanoma cells. The frequency of MMICs has been shown to correlate with poor clinical prognosis in melanoma. In addition, MMICs are enriched among circulating tumor cells in the peripheral blood of cancer patients, suggesting that MMICs may be a critical factor in the metastatic cascade. Although these links exist between MMICs and metastatic disease, the mechanisms by which MMICs may advance metastatic progression are only beginning to be elucidated. Recent studies have shown that MMICs express molecules critical for hematopoietic cell maintenance and trafficking, providing a possible explanation for how circulating MMICs could drive melanoma dissemination. We therefore propose that MMICs might fuel melanoma metastasis by exploiting homing mechanisms commonly utilized by hematopoietic cells. Here we review the biological properties of MMICs and the existing literature on their metastatic potential. We will discuss possible mechanisms by which MMICs might initiate metastases in the context of established knowledge of cancer stem cells in other cancers and of hematopoietic homing molecules, with a particular focus on selectins, integrins, chemokines and chemokine receptors known to be expressed by melanoma cells. Biological understanding of how these molecules might be utilized by MMICs to propel the metastatic cascade could critically impact the development of more effective therapies for advanced disease.
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Affiliation(s)
- Nayoung Lee
- Harvard Skin Disease Research Center, Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Steven R. Barthel
- Harvard Skin Disease Research Center, Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Tobias Schatton
- Harvard Skin Disease Research Center, Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Transplantation Research Center, Children’s Hospital Boston, Harvard Medical School, Boston, MA, USA,To whom correspondence should be addressed: Tobias Schatton, Pharm.D., Ph.D., Department of Dermatology, Brigham and Women’s Hospital, Harvard Institutes of Medicine, Rm. 673B, 77 Avenue Louis Pasteur, Boston, MA 02115, USA;
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23
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Azarjana K, Ozola A, Ruklisa D, Cema I, Rivosh A, Azaryan A, Pjanova D. Melanoma epidemiology, prognosis and trends in Latvia. J Eur Acad Dermatol Venereol 2012; 27:1352-9. [PMID: 23106225 DOI: 10.1111/jdv.12007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Melanoma incidence and mortality rates are increasing worldwide within the white population. Clinical and histological factors have been usually used for the prognosis and assessment of the risk for melanoma. OBJECTIVES The aim of the study was to describe the clinical and histopathological features of the cutaneous melanoma (CM) in the Latvian population, to test the association between melanoma features and patient survival, and to assess the time trends for melanoma incidence. METHODS We undertook a descriptive, retrospective analysis of archive data of 984 melanoma patients treated at the largest oncological hospital of Latvia, Riga East University Hospital Latvian Oncology Centre (LOC), between 1998 and 2008. Cox proportional hazards model was used to analyse patient survival and autoregressive models were applied to detect trends in melanoma incidence over time for various categories of melanoma. RESULTS The study showed a significant ascending trend in melanoma incidence in Latvia during the time period from 1998 to 2008 (ß = 1.83, 95% CI = 1.15-2.91, P = 0.011). Nodular melanoma was the most common tumour subtype with a frequency of 39.2%. Ulceration was present in 45.2% of melanomas. The mean Breslow thickness was 6.0 mm (6.8 mm) and no significant decline in median Breslow thickness was observed during the study period (P = 0.609). A better overall prognosis was detected for females in comparison with males (HR = 1.49; 95% CI = 1.22-1.81; P < 0.001). CONCLUSIONS There is a steady increase in melanoma incidence in Latvia with the majority of melanomas diagnosed at late stages with poor prognosis for survival.
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Affiliation(s)
- K Azarjana
- Department of Oral Pathology, Riga Stradins University, Riga, LatviaLatvian Biomedical Research and Study Centre, Riga, LatviaGenetics Institute, University College London, London, UKRiga East University Hospital Latvian Oncology Centre, Riga, LatviaFaculty of Computing, University of Latvia, Riga, LatviaFaculty of Life Sciences, University of Vienna, Vienna, Austria
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25
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Helm MF, Lin L. Calculating microscope field area is important for accurately determining melanoma mitotic rate. Dermatol Surg 2011; 37:1820-1. [PMID: 22182241 DOI: 10.1111/j.1524-4725.2011.02196.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Oba J, Nakahara T, Hayashida S, Kido M, Xie L, Takahara M, Uchi H, Miyazaki S, Abe T, Hagihara A, Moroi Y, Furue M. Expression of CD10 predicts tumor progression and unfavorable prognosis in malignant melanoma. J Am Acad Dermatol 2011; 65:1152-60. [DOI: 10.1016/j.jaad.2010.10.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 09/30/2010] [Accepted: 10/01/2010] [Indexed: 01/31/2023]
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27
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Corbalán-Vélez R, Oviedo-Ramírez I, Martínez-Barba E, Clemente-Ruiz de Almirón A. Epidermal Effacement in Malignant Melanoma. ACTAS DERMO-SIFILIOGRAFICAS 2011. [DOI: 10.1016/j.adengl.2010.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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28
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Review and cross-validation of gene expression signatures and melanoma prognosis. J Invest Dermatol 2011; 132:274-83. [PMID: 21956122 DOI: 10.1038/jid.2011.305] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In melanoma, there is an urgent need to identify novel biomarkers with prognostic performance superior to traditional clinical and histological parameters. Gene expression-based prognostic signatures offer promise, but studies have been challenged by sample scarcity, cohort heterogeneity, and doubts about the efficacy of such signatures relative to current clinical practices. Motivated by new studies that have begun to address these challenges, we reviewed prognostic signatures derived from gene expression microarray analysis of human melanoma tissue. We used REMARK-based criteria to select the most relevant studies and directly compared their signature gene lists. Through functional ontology enrichment analysis, we observed that these independent data sets converge in part upon immune response processes and the G-protein signaling NRAS-regulation pathway, both important in melanoma development and progression. The signatures correctly predicted patient outcome in independent gene expression data sets with some notably low misclassification rates, particularly among studies involving more advanced-stage tumors. This successful cross-validation indicates that gene expression analysis-based signatures are becoming translationally relevant to care of melanoma patients, as well as improving understanding of the aspects of melanoma biology that determine patient outcome.
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29
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Fallah M, Kharazmi E, Thomsen H, Sundquist J, Hemminki K. Determinants of unfavorable presentation of primary cutaneous melanoma. J Am Acad Dermatol 2011; 65:e5-6. [PMID: 21679807 DOI: 10.1016/j.jaad.2010.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 07/08/2010] [Accepted: 07/16/2010] [Indexed: 02/05/2023]
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30
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Corbalán-Vélez R, Oviedo-Ramírez I, Martínez-Barba E, Clemente-Ruiz de Almirón A. [Epidermal effacement in malignant melanoma]. ACTAS DERMO-SIFILIOGRAFICAS 2011; 102:634-5. [PMID: 21640962 DOI: 10.1016/j.ad.2010.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Revised: 11/03/2010] [Accepted: 11/05/2010] [Indexed: 10/28/2022] Open
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31
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Lages RB, Vieira SC, Abreu BALD, Rodrigues INL, Santos LGD, Cordeiro NM. Sentinel lymph node biopsy in cases of skin melanoma: initial experiences at a center in northeastern Brazil. An Bras Dermatol 2011; 86:379-82. [PMID: 21603830 DOI: 10.1590/s0365-05962011000200030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 03/22/2010] [Indexed: 11/22/2022] Open
Abstract
The incidence of skin melanoma is increasing worldwide. The presence of lymph node metastasis is the most important prognostic factor of this disease, the thicker the lesion the greater the likelihood of lymph node involvement. Approximately 20% of patients with Breslow depth 1-4 mm have lymph node metastasis. Sentinel lymph node biopsy is standard procedure in the management of patients with skin melanoma, reflecting progress in the treatment of this disease since this procedure avoids an unnecessary radical lymphadenectomy, thus reducing the morbidity of treatment. This paper describes a series of cases involving sentinel lymph node biopsy in melanoma patients in Teresina, Piauí, Brazil between 2008 and 2009.
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Affiliation(s)
- Rafael Bandeira Lages
- Bionuclear Diagnostics Center (Centro Bionuclear de Diagnóstico – CBD), São Marcos Hospital and Federal University of Piauí, Piauí, Brazil.
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32
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Gene expression profiling of human angiotropic primary melanoma: Selection of 15 differentially expressed genes potentially involved in extravascular migratory metastasis. Eur J Cancer 2011; 47:1267-75. [DOI: 10.1016/j.ejca.2011.01.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2010] [Revised: 01/06/2011] [Accepted: 01/20/2011] [Indexed: 01/06/2023]
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33
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Baade P, Meng X, Youlden D, Aitken J, Youl P. Time trends and latitudinal differences in melanoma thickness distribution in Australia, 1990-2006. Int J Cancer 2011; 130:170-8. [PMID: 21344376 DOI: 10.1002/ijc.25996] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Accepted: 02/02/2011] [Indexed: 11/08/2022]
Abstract
This study investigated time trends and latitude differentials in the thickness distributions of invasive melanomas diagnosed in Australia between 1990 and 2006 using data from population-based cancer registries. Trends in incidence rates were calculated by sex, age group, thickness, year at diagnosis and latitude. For thin (<1.00 mm) melanomas the increase was very pronounced during the early 1990s (1990-1996, annual percentage change and 95% confidence interval: males +5.6(+3.5,+7.7); females +4.1(+1.7,+6.5), but then incidence rates became stable among both males (+0.6(-0.1,+1.4)) and females (-0.0(-0.9,+0.9)) of all ages between 1996 and 2006. In contrast, incidence of thick (>4.00 mm) melanomas continued to increase over the entire period (males +2.6(+1.9,+3.4); females +1.6(+0.6,+2.6)). Recent reductions in the incidence of thin melanomas were observed among young (<50 years) males and females, contrasted by an increase in thin melanomas among older people, and increases in thick melanomas among most age groups for males and elderly (75+) females. A strong latitude gradient in incidence rates was observed, with rates being highest in northern, more tropical areas and lowest in the most southern regions. However, the magnitude of the increase in thick melanomas was most pronounced in southern parts of Australia. The observed trends in thin melanomas can most likely be attributed to the impact of early detection and skin awareness campaigns. However, these efforts have not impacted on the continued increase in the incidence of thick melanomas, although some increase may be due to earlier detection of metastasising melanomas. This highlights the need for continued vigilance in early detection processes.
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Affiliation(s)
- Peter Baade
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Australia; School of Public Health, Queensland University of Technology, Brisbane, Australia.
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Burton AL, Roach BA, Mays MP, Chen AF, Ginter BA, Vierling AM, Scoggins CR, Martin RC, Stromberg AJ, Hagendoorn L, Mcmasters KM. Prognostic Significance of Tumor Infiltrating Lymphocytes in Melanoma. Am Surg 2011. [DOI: 10.1177/000313481107700219] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prognostic significance of tumor infiltrating lymphocyte (TIL) response in cutaneous melanoma is controversial. This analysis of data from a prospective, randomized trial included patients with cutaneous melanoma ≥ 1.0 mm Breslow thickness who underwent wide local excision and sentinel lymph node (SLN) biopsy. Univariate and multivariate analyses were performed to determine factors associated with TIL response, disease-free survival (DFS), and overall survival (OS). A total of 515 patients were included; TIL response was classified as “brisk” (n = 100; 19.4%) or “non-brisk” (n = 415; 80.6%). Patients in the nonbrisk TIL group were more likely to have tumor-positive SLN (17.6% vs 7%; P = 0.0087). On multivariate analysis, nonbrisk TIL response, increased tumor thickness, and ulceration were significant independent predictors of tumor-positive SLN. By Kaplan-Meier analysis, 5-year DFS rate was 91 per cent for those with a brisk TIL response compared with 86 per cent in the nonbrisk group ( P = 0.41). The 5-year OS rates were 95 per cent versus 84 per cent in the brisk versus nonbrisk TIL groups, respectively ( P = 0.0083). However, on multivariate analysis, TIL response was not a significant independent factor predicting DFS or OS. TIL response is a significant predictor of SLN metastasis but is not a major predictor of DFS or OS.
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Affiliation(s)
- Alison L. Burton
- Department of Surgery, University of Louisville, Louisville, Kentucky
| | - Brent A. Roach
- Department of Surgery, University of Louisville, Louisville, Kentucky
| | - Michael P. Mays
- Department of Surgery, University of Louisville, Louisville, Kentucky
| | - Andrea F. Chen
- Department of Surgery, University of Louisville, Louisville, Kentucky
| | | | - Abbey M. Vierling
- Department of Surgery, University of Louisville, Louisville, Kentucky
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Roach BA, Burton AL, Mays MP, Ginter BA, Martin RCG, Stromberg AJ, Hagendoorn L, McMasters KM, Scoggins CR. Does mitotic rate predict sentinel lymph node metastasis or survival in patients with intermediate and thick melanoma? Am J Surg 2011; 200:759-63; discussion 763-4. [PMID: 21146017 DOI: 10.1016/j.amjsurg.2010.07.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Revised: 07/13/2010] [Accepted: 07/13/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND The significance of mitotic rate (MR) in melanoma remains controversial. METHODS In this retrospective analysis of a prospective randomized trial that included patients with melanoma of 1.0 mm or greater, all patients underwent wide excision and sentinel node (sentinel lymph node [SLN]) biopsy. Univariate and multivariate analyses were performed to evaluate factors predictive of disease-free survival (DFS) and overall survival (OS). RESULTS A total of 551 patients had MR reported. A cut-off point of 6 mitoses/mm(2) best discriminated DFS and OS: 455 patients (82.6%) had MR less than 6/mm(2). SLN were tumor-positive in 14.7% of low MR versus 31.3% of high MR patients (P = .0003). There were significant differences in DFS (P = .0014) and OS (P = .0002) between the 2 groups, however, MR failed to remain significant in the multivariate model. CONCLUSIONS MR is weakly predictive of SLN status but it is not an independent predictor of survival for melanomas 1.0 mm or thicker.
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Affiliation(s)
- Brent A Roach
- Division of Surgical Oncology, Department of Surgery, University of Louisville, James Graham Brown Cancer Center, Louisville, KY 40202, USA
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Boyce Z, Gilmore S, Xu C, Soyer H. The Remote Assessment of Melanocytic Skin Lesions: A Viable Alternative to Face-to-Face Consultation. Dermatology 2011; 223:244-50. [DOI: 10.1159/000333363] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 09/19/2011] [Indexed: 11/19/2022] Open
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Bristow IR, de Berker DA. Development of a practical guide for the early recognition for malignant melanoma of the foot and nail unit. J Foot Ankle Res 2010; 3:22. [PMID: 20920168 PMCID: PMC2954980 DOI: 10.1186/1757-1146-3-22] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Accepted: 09/28/2010] [Indexed: 01/09/2023] Open
Abstract
Background Malignant melanoma is a rare but potentially lethal form of cancer which may arise on the foot. Evidence suggests that due to misdiagnosis and later recognition, foot melanoma has a poorer prognosis than cutaneous melanoma elsewhere. Methods A panel of experts representing podiatry and dermatologists with a special interest in skin oncology was assembled to review the literature and clinical evidence to develop a clinical guide for the early recognition of plantar and nail unit melanoma. Results A systematic review of the literature revealed little high quality data to inform the guide. However a significant number of case reports and series were available for analysis. From these, the salient features were collated and summarised into the guide. Based on these features a new acronym "CUBED" for foot melanoma was drafted and incorporated in the guide. Conclusions The use of this guide may help clinicians in their assessment of suspicious lesions on the foot (including the nail unit). Earlier detection of suspicious pedal lesions may facilitate earlier referral for expert assessment and definitive diagnosis. The guide is currently being field tested amongst practitioners.
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Affiliation(s)
- Ivan R Bristow
- School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK.
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Li M, Zhang B, Sun B, Wang X, Ban X, Sun T, Liu Z, Zhao X. A novel function for vimentin: the potential biomarker for predicting melanoma hematogenous metastasis. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2010; 29:109. [PMID: 20701774 PMCID: PMC2928198 DOI: 10.1186/1756-9966-29-109] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 08/11/2010] [Indexed: 01/08/2023]
Abstract
Background The incidence of malignant melanoma (MM) was occurring at a faster rate than for most neoplasm worldwide, and melanoma metastasis is still the most formidable problem. So it is necessarily to find some biomarkers associated with melanoma metastasis. Methods In our study, 8 spontaneous lung metastatic mice models were created by B16F10 subcutaneously transplantation. The differential protein profiles of two kinds of subcutaneous transplanted tumor tissues, which was parental B16F10 (B16 group) and corresponding lung metastases (B16M group) were detected by two-dimensional differential in-gel electrophoresis (2D-DIGE) combined with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS). Western blotting was used to validate the results, and the clinical significance of individual protein was detected furtherly in a set of human samples. Result In this study, thirty proteins were found to be differentially expressed (ratio > 2 or < -2, P < 0.01) and thirteen of them were identified by MS. Highly expressed proteins in B16M group included cytoskeleton/structure proteins (vimentin, gamma-actin, β-actin, laminin binding protein), the chaperone family of proteins (heavy-chain binding protein, Bip), immunoproteasome assembly (proteasome activator REG alpha) and others involved in glycolysis activity (PGK1, enolase, TPI, human skeletal muscle GAPDH) and protein transport (myoglobin). Vimentin was significantly up-regulated in B16M group compared with B16 group which was validated by western blotting. Immunohistochemistry was performed in a set of clinical samples, the results showed that over-expression of vimentin was frequently observed in primary melanoma patients with hematogenous metastasis (P < 0.05), not associated with lymph node metastasis (P > 0.05). The presence of TNM stage was a independent indicator of poor prognosis for melanoma patients (P = 0.004). Conclusion The aberrant immunohistochemical expression of vimentin in primary melanoma tissues may help to call attention for patients with high risk of hematogenous metastasis. That might be as a novel metastatic indicator for melanoma. In a word, vimentin is not only the dignostic marker but also the hematogenous metastasis predictor for melanomas clinically.
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Affiliation(s)
- Man Li
- Department of Pathology, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Tianjin, People's Republic of China
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Contassot E, Preynat-Seauve O, French L, Huard B. Lymph node tumor metastases: more susceptible than primary tumors to CD8+ T-cell immune destruction. Trends Immunol 2009; 30:569-73. [DOI: 10.1016/j.it.2009.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Revised: 08/25/2009] [Accepted: 08/28/2009] [Indexed: 01/21/2023]
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