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Zaremba A, Jansen P, Murali R, Mayakonda A, Riedel A, Philip M, Rose C, Schaller J, Müller H, Kutzner H, Möller I, Stadtler N, Kretz J, Sucker A, Bankfalvi A, Livingstone E, Zimmer L, Horn S, Paschen A, Plass C, Schadendorf D, Hadaschik E, Lutsik P, Griewank K. Genetic and methylation profiles distinguish benign, malignant and spitzoid melanocytic tumors. Int J Cancer 2022; 151:1542-1554. [PMID: 35737508 PMCID: PMC9474633 DOI: 10.1002/ijc.34187] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/26/2022] [Accepted: 05/04/2022] [Indexed: 11/07/2022]
Abstract
Accurate classification of melanocytic tumors is important for prognostic evaluation, treatment and follow-up protocols of patients. The majority of melanocytic proliferations can be classified solely based on clinical and pathological criteria, however in select cases a definitive diagnostic assessment remains challenging and additional diagnostic biomarkers would be advantageous. We analyzed melanomas, nevi, Spitz nevi and atypical spitzoid tumors using parallel sequencing (exons of 611 genes and 507 gene translocation analysis) and methylation arrays (850k Illumina EPIC). By combining detailed genetic and epigenetic analysis with reference-based and reference-free DNA methylome deconvolution we compared Spitz nevi to nevi and melanoma and assessed the potential for these methods in classifying challenging spitzoid tumors. Results were correlated with clinical and histologic features. Spitz nevi were found to cluster independently of nevi and melanoma and demonstrated a different mutation profile. Multiple copy number alterations and TERT promoter mutations were identified only in melanomas. Genome-wide methylation in Spitz nevi was comparable to benign nevi while the Leukocytes UnMethylation for Purity (LUMP) algorithm in Spitz nevi was comparable to melanoma. Histologically difficult to classify Spitz tumor cases were assessed which, based on methylation arrays, clustered between Spitz nevi and melanoma and in terms of genetic profile or copy number variations demonstrated worrisome features suggesting a malignant neoplasm. Comprehensive sequencing and methylation analysis verify Spitz nevi as an independent melanocytic entity distinct from both nevi and melanoma. Combined genetic and methylation assays can offer additional insights in diagnosing difficult to classify Spitzoid tumors.
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Affiliation(s)
- Anne Zaremba
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Philipp Jansen
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Rajmohan Murali
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Anand Mayakonda
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Helmholtz International Graduate School for Cancer Research, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Anna Riedel
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Helmholtz International Graduate School for Cancer Research, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Manuel Philip
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | | | | | | | - Heinz Kutzner
- Dermatopathologie Friedrichshafen, Medical faculty of the University Leipzig, Leipzig, Germany
| | - Inga Möller
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Nadine Stadtler
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Julia Kretz
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Antje Sucker
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Agnes Bankfalvi
- Department of Pathology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Elisabeth Livingstone
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Lisa Zimmer
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Susanne Horn
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
- Rudolf-Schönheimer-Institute of Biochemistry, Medical faculty of the University Leipzig, Leipzig, Germany
| | - Annette Paschen
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Christoph Plass
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dirk Schadendorf
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Eva Hadaschik
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Pavlo Lutsik
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Klaus Griewank
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Germany, and German Cancer Consortium (DKTK), Heidelberg, Germany
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Mutu DE, Avino A, Balcangiu‑Stroescu AE, Mehedințu M, Bălan D, Brîndușe L, Popescu AM, Ionescu D, Cristea BM, Tomescu L, Jecan CR, Răducu L. Histopathological evaluation of cutaneous malignant melanoma: A retrospective study. Exp Ther Med 2022; 23:402. [PMID: 35601077 PMCID: PMC9115627 DOI: 10.3892/etm.2022.11329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/05/2022] [Indexed: 11/11/2022] Open
Abstract
Malignant melanoma is a melanocytic neoplasm with a steadily increasing incidence worldwide. In order to define a proper diagnostic protocol and to establish an accurate prognostic method for the disease, specific biomarkers are of notable importance. Their contribution is also significant in the treatment of melanoma for the improvement of newer and more targeted therapeutic approaches. To emphasize the importance of specific immune markers in the diagnosis of melanoma, immunohistochemical analysis was performed on 56 formalin-fixed paraffin-embedded cutaneous melanomas. Besides the traditional prognostic factors, depth of invasion and mitotic rate, the markers tested in the present study were S100 protein family, Melan A, Ki67 and HMB-45. The present results indicated that immunocytochemistry represents a valuable test in the diagnosis and treatment of malignant melanoma and each biomarker had different associations with the progression and prognosis of the disease. Patients with S100 expression were 4.83 times (95% CI=1.2-20.8) more likely to suffer a relapse, whereas patients with a Ki67 expression of >30% had a 5.41-fold higher risk (95% CI=1.3-22.0). The correlation between S100 and the Breslow depth was statistically significant (r-value: 0.43; P=0.027). In addition, the importance of a multidisciplinary team including a plastic surgeon, anatomopathologist and oncologist was highlighted.
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Affiliation(s)
- Daniela-Elena Mutu
- Discipline of Anatomy, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 020021, Romani
| | - Adelaida Avino
- Department of Plastic and Reconstructive Surgery, ‘Professor Dr Agrippa Ionescu’ Clinical Emergency Hospital, Bucharest 011356, Romania
| | - Andra-Elena Balcangiu‑Stroescu
- Discipline of Physiology, Faculty of Dental Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 020021, Romania
| | - Mihai Mehedințu
- Department of Plastic and Reconstructive Surgery, ‘Professor Dr Agrippa Ionescu’ Clinical Emergency Hospital, Bucharest 011356, Romania
| | - Daniela Bălan
- Discipline of Physiology, Faculty of Dental Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 020021, Romania
| | - Lăcrămioara Brîndușe
- Discipline of Public Health and Management, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 020021, Romania
| | - Ana-Maria Popescu
- Department of Financial and Economic Analysis and Valuation, Faculty of Accounting and Management Information Systems, Bucharest University of Economic Studies, Bucharest 010731, Romania
| | - Dorin Ionescu
- Department of Medical Semiology, Discipline of Internal Medicine I and Nephrology, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 020021, Romania
| | - Bogdan-Mihai Cristea
- Discipline of Anatomy, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 020021, Romania
| | - Luminiţa Tomescu
- Department of Interventional Radiology, ‘Professor Dr Agrippa Ionescu’ Clinical Emergency Hospital, Bucharest 011356, Romania
| | - Cristian-Radu Jecan
- Department of Plastic and Reconstructive Surgery, ‘Professor Dr Agrippa Ionescu’ Clinical Emergency Hospital, Bucharest 011356, Romania
| | - Laura Răducu
- Department of Plastic and Reconstructive Surgery, ‘Professor Dr Agrippa Ionescu’ Clinical Emergency Hospital, Bucharest 011356, Romania
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Synthetic Evaluation of MicroRNA-1-3p Expression in Head and Neck Squamous Cell Carcinoma Based on Microarray Chips and MicroRNA Sequencing. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6529255. [PMID: 34485523 PMCID: PMC8410410 DOI: 10.1155/2021/6529255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/09/2021] [Indexed: 11/20/2022]
Abstract
Background MicroRNA-1-3p (miR-1-3p) exerts significant regulation in various tumor cells, but its molecular mechanisms in head and neck squamous cell carcinoma (HNSCC) are still ill defined. This study is aimed at detecting the expression of miR-1-3p in HNSCC and at determining its significant regulatory pathways. Methods Data were obtained from the Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), Oncomine, ArrayExpress, Sequence Read Archive (SRA) databases, and additional literature. Expression values of miR-1-3p in HNSCC were analyzed comprehensively. The R language software was employed to screen differentially expressed genes, and bioinformatics assessment was performed. One sequence dataset (HNSCC: n = 484; noncancer: n = 44) and 18 chip datasets (HNSCC: n = 656; noncancer: n = 199) were obtained. Results The expression of miR-1-3p in HNSCC was visibly decreased in compare with noncancerous tissues. There were distinct differences in tumor state (P = 0.0417), pathological stage (P = 0.0058), and T stage (P = 0.0044). Comprehensive analysis of sequence and chip data also indicated that miR-1-3p was lowly expressed in HNSCC. The diagnostic performance of miR-1-3p in HNSCC is reflected in the sensitivity and specificity of the collection, etc. Bioinformatics analysis showed the possible biological process, cellular component, molecular function, and KEGG pathways of miR-1-3p in HNSCC. And ITGB4 was a possible target of miR-1-3p. Conclusions miR-1-3p's low expression may facilitate tumorigenesis and evolution in HNSCC through signaling pathways. ITGB4 may be a key gene in targeting pathways but still needs verification through in vitro experiments.
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Rouillé T, Aractingi S, Kadlub N, Fraitag S, How-Kit A, Daunay A, Hivelin M, Moguelet P, Picard A, Fontaine RH, Guégan S. Local Inhibition of MEK/Akt Prevents Cellular Growth in Human Congenital Melanocytic Nevi. J Invest Dermatol 2019; 139:2004-2015.e13. [PMID: 31059696 DOI: 10.1016/j.jid.2019.03.1156] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 03/20/2019] [Accepted: 03/26/2019] [Indexed: 12/15/2022]
Abstract
The management of large congenital melanocytic nevi (lCMN) is based exclusively on iterative surgical procedures in the absence of validated medical therapy. The aim of our study was to develop an intra-lesional medical treatment for lCMN. Seventeen patients harboring NRAS-mutated lCMN were included. Nevocytes obtained from lCMN displayed an overactivation of mitogen-activated protein kinase and phosphoinositide 3-kinase (Akt) pathways. Mitogen-activated protein kinase/extracellular signal-regulated kinase (MEK) and Akt inhibitors reduced the nevosphere diameter in sphere-forming assays, as well as cell viability and proliferation in in vitro assays. Standardized lCMN explants were then cultured ex vivo with the same inhibitors, which induced a decrease in MelanA+ and Sox10+ cells in both epidermis and dermis. Finally, intradermal injections of these inhibitors were administered within standardized lCMN xenografts in Rag2-/- mice. They induced a dramatic decrease in nevocytes in treated xenografts, which persisted 30 days after the end of treatment. Using original nevus explant and xenograft preclinical models, we demonstrated that intradermal MEK/Akt inhibition might serve as neoadjuvant therapy for the treatment of NRAS-mutated congenital melanocytic nevi to avoid iterative surgeries.
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Affiliation(s)
- Thomas Rouillé
- Saint-Antoine Research Center, INSERM UMRS_938, Paris, France; Sorbonne Université, Paris, France
| | - Selim Aractingi
- Saint-Antoine Research Center, INSERM UMRS_938, Paris, France; Université Paris-Descartes, Paris, France; AP-HP, Hôpital Cochin, Department of Dermatology, Paris, France
| | - Natacha Kadlub
- Université Paris-Descartes, Paris, France; AP-HP, Hôpital Necker-Enfants-Malades, Department of Maxillofacial and Plastic Surgery, Paris, France
| | - Sylvie Fraitag
- AP-HP, Hôpital Necker-Enfants-Malades, Department of Pathology, Paris, France
| | - Alexandre How-Kit
- Laboratory for Functional Genomics, Fondation Jean Dausset-CEPH, Paris, France
| | - Antoine Daunay
- Laboratory for Functional Genomics, Fondation Jean Dausset-CEPH, Paris, France
| | - Mikael Hivelin
- Université Paris-Descartes, Paris, France; AP-HP, Hôpital Européen Georges-Pompidou, Department of Plastic Surgery, Paris, France
| | | | - Arnaud Picard
- Université Paris-Descartes, Paris, France; AP-HP, Hôpital Necker-Enfants-Malades, Department of Maxillofacial and Plastic Surgery, Paris, France
| | - Romain H Fontaine
- Saint-Antoine Research Center, INSERM UMRS_938, Paris, France; Sorbonne Université, Paris, France
| | - Sarah Guégan
- Saint-Antoine Research Center, INSERM UMRS_938, Paris, France; Université Paris-Descartes, Paris, France; AP-HP, Hôpital Cochin, Department of Dermatology, Paris, France.
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5
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Riefolo M, Porcellini E, Dika E, Broseghini E, Ferracin M. Interplay between small and long non-coding RNAs in cutaneous melanoma: a complex jigsaw puzzle with missing pieces. Mol Oncol 2019; 13:74-98. [PMID: 30499222 PMCID: PMC6322194 DOI: 10.1002/1878-0261.12412] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 10/20/2018] [Accepted: 10/23/2018] [Indexed: 12/12/2022] Open
Abstract
The incidence of cutaneous melanoma (CM) has increased in the past few decades. The biology of melanoma is characterized by a complex interaction between genetic, environmental and phenotypic factors. A greater understanding of the molecular mechanisms that promote melanoma cell growth and dissemination is crucial to improve diagnosis, prognostication, and treatment of CM. Both small and long non-coding RNAs (lncRNAs) have been identified to play a role in melanoma biology; microRNA and lncRNA expression is altered in transformed melanocytes and this in turn has functional effects on cell proliferation, apoptosis, invasion, metastasis, and immune response. Moreover, specific dysregulated ncRNAs were shown to have a diagnostic or prognostic role in melanoma and to drive the establishment of drug resistance. Here, we review the current literature on small and lncRNAs with a role in melanoma, with the aim of putting into some order this complex jigsaw puzzle.
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Affiliation(s)
- Mattia Riefolo
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES)University of BolognaItaly
| | - Elisa Porcellini
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES)University of BolognaItaly
| | - Emi Dika
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES)University of BolognaItaly
| | - Elisabetta Broseghini
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES)University of BolognaItaly
| | - Manuela Ferracin
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES)University of BolognaItaly
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6
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Richetta AG, Valentini V, Marraffa F, Paolino G, Rizzolo P, Silvestri V, Zelli V, Carbone A, Di Mattia C, Calvieri S, Frascione P, Donati P, Ottini L. Metastases risk in thin cutaneous melanoma: prognostic value of clinical-pathologic characteristics and mutation profile. Oncotarget 2018; 9:32173-32181. [PMID: 30181807 PMCID: PMC6114949 DOI: 10.18632/oncotarget.25864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 07/13/2018] [Indexed: 11/25/2022] Open
Abstract
Background A high percentage of patients with thin melanoma (TM), defined as lesions with Breslow thickness ≤1 mm, presents excellent long-term survival, however, some patients develop metastases. Existing prognostic factors cannot reliably differentiate TM patients at risk for metastases. Objective We aimed at characterizing the clinical-pathologic and mutation profile of metastatic and not-metastatic TM in order to distinguish lesions at risk of metastases. Methods Clinical-pathologic characteristics were recorded for the TM cases analyzed. We used a Next Generation Sequencing (NGS) multi-gene panel to characterize TM for multiple somatic mutations. Results A statistically significant association emerged between the presence of metastases and Breslow thickness ≥0.6 mm (p=0.003). None of TM with lymph-node involvement had Breslow thickness <0.6 mm. Somatic mutations were identified in 19 of 21 TM analyzed (90.5%). No mutations were observed in two not-metastatic cases with the lowest Breslow thickness (≤0.4 mm), whereas mutations in more than one gene were detected in one metastatic case with the highest Breslow thickness (1.00 mm). Conclusion Our study indicates Breslow thickness ≥0.6 mm as a valid prognostic factor to distinguish TM at risk for metastases.
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Affiliation(s)
- Antonio G Richetta
- Department of Internal Medicine and Medical Specialties, Unit of Dermatology, "Sapienza" University of Rome, Rome, Italy
| | - Virginia Valentini
- Department of Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Federica Marraffa
- Department of Internal Medicine and Medical Specialties, Unit of Dermatology, "Sapienza" University of Rome, Rome, Italy
| | - Giovanni Paolino
- Department of Internal Medicine and Medical Specialties, Unit of Dermatology, "Sapienza" University of Rome, Rome, Italy.,Unit of Dermatology and Cosmetology, IRCCS, University Vita-Salute San Raffaele, Milan, Italy
| | - Piera Rizzolo
- Department of Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Valentina Silvestri
- Department of Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Veronica Zelli
- Department of Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Anna Carbone
- Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Cinzia Di Mattia
- Laboratory of Cutaneous Histopathology, San Gallicano Dermatologic Institute, Rome, Italy
| | - Stefano Calvieri
- Department of Internal Medicine and Medical Specialties, Unit of Dermatology, "Sapienza" University of Rome, Rome, Italy
| | - Pasquale Frascione
- Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Pietro Donati
- Laboratory of Cutaneous Histopathology, San Gallicano Dermatologic Institute, Rome, Italy
| | - Laura Ottini
- Department of Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
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Moon KR, Choi YD, Kim JM, Jin S, Shin MH, Shim HJ, Lee JB, Yun SJ. Genetic Alterations in Primary Acral Melanoma and Acral Melanocytic Nevus in Korea: Common Mutated Genes Show Distinct Cytomorphological Features. J Invest Dermatol 2018; 138:933-945. [PMID: 29191620 DOI: 10.1016/j.jid.2017.11.017] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 10/31/2017] [Accepted: 11/14/2017] [Indexed: 12/18/2022]
Abstract
Acral melanoma occurring on the palms, soles, and nails is the most common subtype of cutaneous melanoma in Asians. Genetic alterations in acral melanoma and acral melanocytic nevus are not well known. We performed next-generation sequencing and evaluated the correlations between genetic information and the clinicopathologic characteristics from 85 Korean patients with acral melanocytic neoplasms. Of the 64 patients with acral melanoma, most had lesions at the T2 stage or higher, and the heel was the most common anatomical site of melanoma (n = 34 [53.1%]). The five most common mutations were BRAF (22 [34.4%]), NRAS (14, [21.9%]), NF1 (11, [17.2%]), GNAQ (12, [17.2%]), and KIT (7, [10.9%]). In the 21 acral melanocytic nevi, those five gene mutations were also common. Copy number variations were also frequently detected in 75% of acral melanomas and 47.6% of acral melanocytic nevi, and amplification was more common than deletion in both lesions. BRAF mutation was associated with round epithelioid cells and NRAS and NF1 mutations with bizarre cells. NF1 and GNAQ mutations showed elongated and spindle cells with prominent dendrites in acral melanomas. KIT mutations were common in amelanotic acral melanoma. This study suggests that common mutated genes are associated with distinct cytomorphological features in acral melanocytic lesions.
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Affiliation(s)
- Ki Rang Moon
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, South Korea
| | - Jung Min Kim
- Department of Pharmacology, Chonnam National University Medical School, Gwangju, South Korea
| | - Suna Jin
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Hyun-Jeong Shim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea.
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Tetzlaff MT, Reuben A, Billings SD, Prieto VG, Curry JL. Toward a Molecular-Genetic Classification of Spitzoid Neoplasms. Clin Lab Med 2017; 37:431-448. [DOI: 10.1016/j.cll.2017.05.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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9
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Amérigo-Góngora M, Machuca-Portillo G, Torres-Lagares D, Lesclous P, Amérigo-Navarro J, González-Cámpora R. Clinicopathological and immunohistochemical analysis of oral melanocytic nevi and review of the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:151-155. [DOI: 10.1016/j.jormas.2017.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 12/27/2016] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
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10
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Xia Y, Li Y, Westover KD, Sun J, Chen H, Zhang J, Fisher DE. Inhibition of Cell Proliferation in an NRAS Mutant Melanoma Cell Line by Combining Sorafenib and α-Mangostin. PLoS One 2016; 11:e0155217. [PMID: 27152946 PMCID: PMC4859503 DOI: 10.1371/journal.pone.0155217] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/26/2016] [Indexed: 12/19/2022] Open
Abstract
α-Mangostin is a natural product commonly used in Asia for cosmetic and medicinal applications including topical treatment of acne and skin cancer. Towards finding new pharmacological strategies that overcome NRAS mutant melanoma, we performed a cell proliferation-based combination screen using a collection of well-characterized small molecule kinase inhibitors and α-Mangostin. We found that α-Mangostin significantly enhances Sorafenib pharmacological efficacy against an NRAS mutant melanoma cell line. The synergistic effects of α-Mangostin and Sorafenib were associated with enhanced inhibition of activated AKT and ERK, induced ER stress, and reduced autophagy, eventually leading to apoptosis. The structure of α-Mangostin resembles several inhibitors of the Retinoid X receptor (RXR). MITF expression, which is regulated by RXR, was modulated by α-Mangostin. Molecular docking revealed that α-Mangostin can be accommodated by the ligand binding pocket of RXR and may thereby compete with RXR-mediated control of MITF expression. In summary, these data demonstrate an unanticipated synergy between α-Mangostin and sorafenib, with mechanistic actions that convert a known safe natural product to a candidate combinatorial therapeutic agent.
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Affiliation(s)
- Yun Xia
- Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Cutaneous Biology Research Center, Massachusetts General Hospital, 149 Building 13th ST, Charlestown, Massachusetts, United States of America
| | - Ying Li
- Cutaneous Biology Research Center, Massachusetts General Hospital, 149 Building 13th ST, Charlestown, Massachusetts, United States of America
- Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, No.7 Front Kangfu ST, Zhengzhou 450052, China
| | - Kenneth D. Westover
- Departments of Biochemistry and Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America
| | - Jiaming Sun
- Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongxiang Chen
- Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Cutaneous Biology Research Center, Massachusetts General Hospital, 149 Building 13th ST, Charlestown, Massachusetts, United States of America
| | - Jianming Zhang
- Cutaneous Biology Research Center, Massachusetts General Hospital, 149 Building 13th ST, Charlestown, Massachusetts, United States of America
| | - David E. Fisher
- Cutaneous Biology Research Center, Massachusetts General Hospital, 149 Building 13th ST, Charlestown, Massachusetts, United States of America
- * E-mail:
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Martinelli-Kläy CP, Laporte ML, Martinelli CR, Martinelli C, Lombardi T. Oral Malignant Melanoma Initially Misdiagnosed as a Racial Pigmentation: A Case Report. Dermatopathology (Basel) 2016; 3:1-7. [PMID: 27195264 PMCID: PMC4868936 DOI: 10.1159/000444049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Oral malignant melanoma (OMM) is rare, representing less than 0.5% of all oral malignancies. The most affected sites are the palate and the maxillary gingiva. Histological examination is important to establish the diagnosis of any suspicious pigmented lesion in the oral cavity, mainly if a precise clinical diagnosis is not possible. We present one case of OMM that was initially diagnosed as a racial pigmentation elsewhere 2 years earlier. Clinical examination showed multiple macules and nodules located on the hard and soft palate, gingiva and superior alveolar mucosa. These lesions were painless and presented a color variation going from dark blue to black. Histological analysis showed sheets and nests of atypical melanocytes displaying a range of shapes such as plasmacytoid, epithelioid, and round cells, located in the superficial corium extending to the deep tissues. A few tumor cells contained variable amounts of melanin. There was no invasion of blood vessels or nerve fibers. Immunohistochemical analysis revealed that the neoplastic cells were positive for HMB-45, melan-A, S-100 and negative for AE1/AE3, confirming the diagnosis of melanoma. The Ki-67 labeling index was around 25%. The patient refused any treatment and died 11 months later.
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Affiliation(s)
- Carla Patrícia Martinelli-Kläy
- Oral Medicine and Oral Maxillofacial Pathology Unit, Division of Oral Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals and Faculty of Geneva, Geneva, Switzerland; Centre for Diagnosis and Treatment of Oral Diseases, Ribeirão Preto, Brazil
| | - Marcel Leandro Laporte
- Oral Medicine and Oral Maxillofacial Pathology Unit, Division of Oral Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals and Faculty of Geneva, Geneva, Switzerland
| | | | - Celso Martinelli
- Centre for Diagnosis and Treatment of Oral Diseases, Ribeirão Preto, Brazil
| | - Tommaso Lombardi
- Oral Medicine and Oral Maxillofacial Pathology Unit, Division of Oral Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals and Faculty of Geneva, Geneva, Switzerland
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12
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Abstract
Pediatric melanoma is rare and given the diagnostic challenges it presents in this age group, it is difficult to interpret the literature describing its natural history and outcome. Recent genomic analysis demonstrates that conventional melanoma in children and adolescents shares many of the genomic features that have been described in adult melanoma, including BRAF mutations. Thus, this patient group should be given the opportunity to enroll in National Cancer Institute and pharmaceutically sponsored trials that incorporate novel targeted agents.
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Affiliation(s)
- Alberto S Pappo
- From the Solid Tumor Division, St. Jude Children's Research Hospital, Memphis, TN
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13
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Oral melanocytic nevi: a clinicopathologic study of 100 cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:358-67. [PMID: 26297393 DOI: 10.1016/j.oooo.2015.05.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 05/07/2015] [Accepted: 05/11/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the clinical and histopathologic features of oral melanocytic nevi (OMN). STUDY DESIGN One hundred cases of OMN were retrieved from the files of two oral pathology services, and the data were analyzed with regard to histologic type and clinical features. RESULTS Intramucosal nevus was the most common type (61%), followed by common blue nevus (23%), compound nevus (7%), and junctional nevus (3%). Combined nevus and cellular blue nevus were rare (2% each). The hard palate was the most commonly affected site (33%), followed by the buccal mucosa (18%), vermilion border of the lip (18%), and gingiva (15%). An interesting case of intramucosal nevus with lipomatosus-like changes and neurotization and two cases of oral dysplastic nevus are also reported. CONCLUSIONS Intramucosal and common blue nevi are the most common types of OMN. Dysplastic nevus, which is recognized as a marker for melanoma in the skin, can rarely involve the oral cavity. Accordingly, dentists, especially oral and maxillofacial pathologists, should become familiar with the clinical and histopathologic features of this entity.
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14
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Loaiza-Bonilla A, Clayton E, Furth E, O'Hara M, Morrissette J. Dramatic response to dabrafenib and trametinib combination in a BRAF V600E-mutated cholangiocarcinoma: implementation of a molecular tumour board and next-generation sequencing for personalized medicine. Ecancermedicalscience 2014; 8:479. [PMID: 25435907 PMCID: PMC4239128 DOI: 10.3332/ecancer.2014.479] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Indexed: 12/12/2022] Open
Abstract
This is the case of a 47-year-old woman diagnosed with chemotherapy and radiation-refractory BRAF V600E mutant, poorly differentiated intrahepatic cholangiocarcinoma (ICC), with multiple metastatic lesions within the liver, lungs, pleura, and bone, stage IV. Discussion of her malignancy's next-generation sequencing genomic information at a multidisciplinary molecular tumour board took place. The patient was considered a suitable candidate for dual BRAF and MEK inhibition, with the intent to prolong her survival and optimize the quality of life. We report her excellent tolerance and exceptional response to dual therapy with dabrafenib and trametinib, including symptomatic and sustained near-complete radiological improvement. We also briefly review the current knowledge of the genomics of cholangiocarcinoma with a focus on BRAF mutations, and make a point of the importance of the establishment of a molecular tumour board for personalized genomic medicine approaches. To our knowledge, this is the first reported case of the use of personalized genomic information for the successful management of a patient with ICC, and it is also the first description of dual BRAF and MEK targeted therapy in this malignancy, leading to what is considered an exceptional response.
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Affiliation(s)
- Arturo Loaiza-Bonilla
- Abramson Cancer Center of the University of Pennsylvania, Perelman Center for Advanced Medicine, Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Erica Clayton
- Abramson Cancer Center of the University of Pennsylvania, Perelman Center for Advanced Medicine, Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Emma Furth
- Abramson Cancer Center of the University of Pennsylvania, Perelman Center for Advanced Medicine, Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Mark O'Hara
- Abramson Cancer Center of the University of Pennsylvania, Perelman Center for Advanced Medicine, Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Jennifer Morrissette
- Abramson Cancer Center of the University of Pennsylvania, Perelman Center for Advanced Medicine, Civic Center Boulevard, Philadelphia, PA 19104, USA
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15
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Wilson MA, Morrissette JJD, McGettigan S, Roth D, Elder D, Schuchter LM, Daber RD. What you are missing could matter: a rare, complex BRAF mutation affecting codons 599, 600, and 601 uncovered by next generation sequencing. Cancer Genet 2014; 207:272-5. [PMID: 25178945 DOI: 10.1016/j.cancergen.2014.06.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 05/28/2014] [Accepted: 06/10/2014] [Indexed: 01/01/2023]
Abstract
Testing for somatic mutations in tumor samples is becoming standard practice in a number of tumor types where targeted therapies are available. Since clinical care is dependent on the identification of the presence or absence of specific mutations, it is important that these mutations be identified consistently and accurately. Here we identify in a patient with metastatic melanoma a novel, complex mutation involving BRAF c.1798A>T (p.T599T), c.1799T>A (p.V600E), and c.1803A>T (p.K601N) that was identified by next generation sequencing but not by standard testing methods. The patient was started on a combination therapy inhibiting both BRAF and MEK, and demonstrated a dramatic clinical response. This case highlights the need for improved methods of mutation testing in tumor samples and exposes a pitfall in allele-specific testing methods that can be overcome using next generation sequencing.
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Affiliation(s)
- Melissa A Wilson
- Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jennifer J D Morrissette
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Suzanne McGettigan
- Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - David Roth
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - David Elder
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Lynn M Schuchter
- Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Robert D Daber
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
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16
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Abbas O, Miller DD, Bhawan J. Cutaneous malignant melanoma: update on diagnostic and prognostic biomarkers. Am J Dermatopathol 2014; 36:363-79. [PMID: 24803061 DOI: 10.1097/dad.0b013e31828a2ec5] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The incidence of cutaneous malignant melanoma has rapidly increased in recent years in all parts of the world, and melanoma is a leading cause of cancer death. As even relatively small melanomas may have metastatic potential, accurate assessment of progression is critical. Although diagnosis of cutaneous malignant melanoma is usually based on histopathologic criteria, these criteria may at times be inadequate in differentiating melanoma from certain types of benign nevi. As for prognosis, tumor (Breslow) thickness, mitotic rate, and ulceration have been considered the most important prognostic indicators among histopathologic criteria. However, there are cases of thin primary melanomas that have ultimately developed metastases despite complete excision. Given this, an accurate assessment of melanoma progression is critical, and development of molecular biomarkers that identify high-risk melanoma in its early phase is urgently needed. Large-scale genomic profiling has identified considerable heterogeneity in melanoma and suggests subgrouping of tumors by patterns of gene expression and mutation will ultimately be essential to accurate staging. This subgrouping in turn may allow for more targeted therapy. In this review, we aim to provide an update on the most promising new biomarkers that may help in the identification and prognostication of melanoma.
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Affiliation(s)
- Ossama Abbas
- *Associate Professor of Clinical Dermatology, Dermatology Department, American University of Beirut-Medical Center, Beirut, Lebanon; and †Assistant Professor of Dermatology (D.D.M.), Professor of Dermatology and Pathology (J.B.), Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, MA
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17
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Molecular pathology of malignant melanoma: changing the clinical practice paradigm toward a personalized approach. Hum Pathol 2014; 45:1315-26. [PMID: 24856851 DOI: 10.1016/j.humpath.2014.04.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/04/2014] [Accepted: 04/09/2014] [Indexed: 12/14/2022]
Abstract
Melanocytic proliferations are notoriously difficult lesions to evaluate histologically, even among experts, as there is a lack of objective, highly reproducible criteria, which can be broadly applied to the wide range of melanocytic lesions encountered in daily practice. These difficult diagnoses are undeniably further compounded by the substantial medicolegal risks of an "erroneous" diagnosis. Molecular information and classification of melanocytic lesions is already vast and constantly expanding. The application of molecular techniques for the diagnosis of benignity or malignancy is, at times, confusing and limits its utility if not used properly. In addition, current and future therapies will necessitate molecular classification of melanoma into one of several distinct subtypes for appropriate patient-specific therapy. An understanding of what different molecular markers can and cannot predict is of the utmost importance. We discuss both mutational analysis and chromosomal gains/losses to help clarify this continually developing and confusing facet of pathology.
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18
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NRAS mutation is the sole recurrent somatic mutation in large congenital melanocytic nevi. J Invest Dermatol 2014; 134:1067-1074. [PMID: 24129063 DOI: 10.1038/jid.2013.429] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 08/25/2013] [Accepted: 09/25/2013] [Indexed: 02/03/2023]
Abstract
Congenital melanocytic nevus (CMN) is a particular melanocytic in utero proliferation characterized by an increased risk of melanoma transformation during infancy or adulthood. NRAS and BRAF mutations have consistently been reported in CMN samples, but until recently results have been contradictory. We therefore studied a series of large and giant CMNs and compared them with small and medium CMNs using Sanger sequencing, pyrosequencing, high-resolution melting analysis, and mutation enrichment by an enhanced version of ice-COLD-PCR. Large-giant CMNs displayed NRAS mutations in 94.7% of cases (18/19). At that point, the role of additional mutations in CMN pathogenesis had to be investigated. We therefore performed exome sequencing on five specimens of large-giant nevi. The results showed that NRAS mutation was the sole recurrent somatic event found in such melanocytic proliferations. The genetic profile of small-medium CMNs was significantly different, with 70% of cases bearing NRAS mutations and 30% showing BRAF mutations. These findings strongly suggest that NRAS mutations are sufficient to drive melanocytic benign proliferations in utero.
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19
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Shenolikar S. Dangerous liaisons: flirtations between oncogenic BRAF and GRP78 in drug-resistant melanomas. J Clin Invest 2014; 124:973-6. [PMID: 24569370 DOI: 10.1172/jci74609] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BRAF mutations in aggressive melanomas result in kinase activation. BRAF inhibitors reduce BRAF(V600E) tumors, but rapid resistance follows. In this issue of the JCI, Ma and colleagues report that vemurafenib activates ER stress and autophagy in BRAF(V600E) melanoma cells, through sequestration of the ER chaperone GRP78 by the mutant BRAF and subsequent PERK activation. In preclinical studies, treating vemurafenib-resistant melanoma with a combination of vemurafenib and an autophagy inhibitor reduced tumor load. Further work is needed to establish clinical relevance of this resistance mechanism and demonstrate efficacy of autophagy and kinase inhibitor combinations in melanoma treatment.
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20
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Richetta AG, Silvestri V, Giancristoforo S, Rizzolo P, D'Epiro S, Graziano V, Mattozzi C, Navazio AS, Falchetti M, Calvieri S, Ottini L. Mutational Profiling in Melanocytic Tumors: Multiple Somatic Mutations and Clinical Implications. Oncology 2014; 86:104-8. [DOI: 10.1159/000356878] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 10/22/2013] [Indexed: 11/19/2022]
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21
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Perier-Muzet M, Thomas L, Poulalhon N, Debarbieux S, Bringuier PP, Duru G, Depaepe L, Balme B, Dalle S. Melanoma patients under vemurafenib: prospective follow-up of melanocytic lesions by digital dermoscopy. J Invest Dermatol 2013; 134:1351-1358. [PMID: 24304815 DOI: 10.1038/jid.2013.462] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 09/12/2013] [Accepted: 09/24/2013] [Indexed: 12/22/2022]
Abstract
Second primary melanomas (SPMs) induced by vemurafenib have been recently described. The aim of this study was to define the dermoscopical signs of melanoma in this context. Patients underwent a total body examination before receiving vemurafenib. Each single melanocytic lesion was registered before therapy by digital dermoscopy (DD), and then repeated monthly until therapy disruption. Forty-two patients were included, the mean duration of follow-up was 6.7 months, and a mean number of 51 lesions per patients were captured and followed. A total number of 2,155 lesions were recorded, of which 56.1% presented at least one change during the study. More common changes concerned the color of the lesions (up to 15%) and appearance or disappearance of globules (14.6%). Thirty-six of the melanocytic lesions were surgically excised, 21 were classified as a nevus, 1 was a lentigo, and 14 as a second new primary melanoma (occurring in 21% of our patients). DD allowed us to excise only 36/2,155 (1.6%) of the lesions and permitted us to detect 14 SPM in the 42 patients with a highly efficient malignant/benign ratio of 63.6%. Although vemurafenib is now tested in an adjuvant setting DD should be systematically used in order to accurately detect SPM and reduce the number of unnecessary excisions.
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Affiliation(s)
- Marie Perier-Muzet
- Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France
| | - Luc Thomas
- Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France
| | - Nicolas Poulalhon
- Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France
| | - Sébastien Debarbieux
- Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France
| | - Pierre-Paul Bringuier
- Université Claude Bernard Lyon 1, Lyon, France; Cancer Research Center of Lyon, Lyon, France; Unit of Pathology, Centre Hospitalier Lyon-Sud, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Gerard Duru
- Université Claude Bernard Lyon 1, Lyon, France
| | - Lauriane Depaepe
- Unit of Pathology, Centre Hospitalier Lyon-Sud, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Brigitte Balme
- Unit of Pathology, Centre Hospitalier Lyon-Sud, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Stephane Dalle
- Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France; Cancer Research Center of Lyon, Lyon, France.
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22
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Drukker L, Margulis A, Chaouat M, Levitzki R, Maiorenko E, Ben Bassat H. Changes of PI3K/AKT/BCL2 signaling proteins in congenital Giant Nevi: melanocytes contribute to their increased survival and integrity. J Recept Signal Transduct Res 2013; 33:359-66. [PMID: 24069951 DOI: 10.3109/10799893.2013.838785] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Congenital Giant Nevi (CGN) are rare melanocytic lesions with the potential to regress into malignant melanoma. Simultaneous up-regulation and cooperative interactions of signaling pathways are crucial events in the pathogenesis of melanocytes. Our study aimed to identify changes in the expression and activation of proteins controlling survival and/or apoptosis of the key signaling pathways PI3K/AKT/BCL2 and Wnt/β-catenin of CGN melanocytes. We applied a model of cultured melanocytes from paired CGN and normal appearing skin, and Western blot (WB) analyzed the expression and activation profile of survival and anti-apoptotic proteins of these signaling pathways, growth pattern, cell cycle and apoptosis. WB analysis demonstrated a significant higher expression level of activated AKT and of BCL2 proteins in the CGN melanocytes compared with paired melanocytes from normal appearing skin. A relative increase in the level of GSK3 and FOXO1 proteins, down stream targets of AKT, as well as of pβ-catenin was also detected in the CGN melanocytes compared with the controls. These changes were not affected by growth of the CGN melanocytes in reduced serum (starvation). Both cell populations shared a similar growth pattern, with no significant differences in the proportion of apoptotic cells and in cell cycle fractions. These data demonstrate for the first time, changes in signaling proteins of cultured CGN melanocytes. Further, suggesting that the changes in AKT/BCL2 signaling molecules might mediate growth and anti-apoptosis processes at least in part, thus increasing the survival potential of CGN melanocytes and maintaining their integrity.
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Affiliation(s)
- Lior Drukker
- Israel National Skin Bank-Laboratory of Experimental Surgery and
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23
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Melanoma genotypes and phenotypes get personal. J Transl Med 2013; 93:858-67. [PMID: 23817084 DOI: 10.1038/labinvest.2013.84] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 05/28/2013] [Accepted: 06/01/2013] [Indexed: 01/23/2023] Open
Abstract
Traditionally, the diagnosis of metastatic melanoma was terminal to most patients. However, the advancements towards understanding the fundamental etiology, pathophysiology, and treatment have raised melanoma to the forefront of contemporary medicine. Indeed, the evidence of durable remissions are being heard ever more frequently in clinics around the globe. Despite having more gene mutations per cell than any other type of cancer, investigators are overcoming complex genomic landscapes, signaling pathways, and immune checkpoints by generating novel technological methods and clinical protocols with breath-taking speed. Significant progress in deciphering molecular genetics, epigenetics, kinase-driven networks, metabolomics, and immune-enhancing pathways to achieve personalized and positive outcomes has truly provided new hope for melanoma patients. However, obstacles requiring breakthroughs include understanding the influence of sunlight exposure on melanoma etiology, and overcoming all too frequently acquired drug resistance, complicating targeted therapy. Pathologists continue to have critically important roles in advancing the field, particularly in the area of transitioning from microscope-based diagnostic reports to pharmacogenomics through molecularly informed tumor boards. Although melanoma is no longer considered just 'one disease', pathologists will continue this rapidly progressing and exciting journey to identify tumor subtypes, to utilize tumorgraft or so-called patient-derived xenograft (PDX) models, and to develop companion diagnostics to keep pace with the bewildering breakthroughs occurring on a regular basis. Exactly which combination of drugs will ultimately be required to eradicate melanoma cells remains to be determined. However, it is clear that pathologists who are as dedicated to melanoma as the pioneering pathologist Dr Sidney Farber was committed to childhood cancers, will be required as the battle against melanoma continues. In this review, we describe what sets melanoma apart from other tumors, and demonstrate how lessons learned in the melanoma clinic are being transferred to many other types of aggressive neoplasms.
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Gessi M, Hammes J, Lauriola L, Dörner E, Kirfel J, Kristiansen G, zur Muehlen A, Denkhaus D, Waha A, Pietsch T. GNA11andN-RASmutations: alternatives for MAPK pathway activating GNAQ mutations in primary melanocytic tumours of the central nervous system. Neuropathol Appl Neurobiol 2013; 39:417-25. [DOI: 10.1111/j.1365-2990.2012.01288.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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25
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Murphy MJ, Rezaul K, Phelps A, Han DK. Proteomic analysis of formalin-fixed, paraffin-embedded melanoma. J Cutan Pathol 2012; 39:464-6. [DOI: 10.1111/j.1600-0560.2011.01835.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Swick JM, Maize JC. Molecular biology of melanoma. J Am Acad Dermatol 2012; 67:1049-54. [PMID: 22459362 DOI: 10.1016/j.jaad.2011.06.047] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Revised: 06/03/2011] [Accepted: 06/07/2011] [Indexed: 01/06/2023]
Abstract
Dermatologists and dermatopathologists face the difficulties of accurately diagnosing and treating atypical melanocytic lesions and melanomas. Despite huge advances in medicine, our management of melanoma has not significantly changed in many years. The biggest gains made recently have been in the identification of common mutations in melanoma and the use of these mutations to aid in the diagnosis and treatment of melanoma. To understand these gains one must first be familiar with the regulatory pathways of melanoma and the most common mutations found there. This article will review the function and significance of the most studied mutations in melanoma and briefly discuss new and planned treatment options.
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Affiliation(s)
- Julie M Swick
- Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
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27
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Yang L, Chen Y, Cui T, Knösel T, Zhang Q, Geier C, Katenkamp D, Petersen I. Identification of biomarkers to distinguish clear cell sarcoma from malignant melanoma. Hum Pathol 2012; 43:1463-70. [PMID: 22406360 DOI: 10.1016/j.humpath.2011.10.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 10/10/2011] [Accepted: 10/11/2011] [Indexed: 02/06/2023]
Abstract
Clear cell sarcoma is a rare and malignant soft tissue tumor that shows phenotypic and immunohistochemical overlap with cutaneous malignant melanoma; identification of biomarkers that differentiate clear cell sarcoma from malignant melanoma is therefore needed. In this study, we performed mutation analysis of BRAF and NRAS, investigated the EWSR1 gene rearrangement and evaluated the protein expression of insulin-like growth factor 2 and insulin-like growth factor 1R in 31 cases of malignant melanoma and 16 cases of clear cell sarcoma. By direct sequencing and high-resolution melting analysis, we identified BRAF and NRAS mutations in 51.6% and 12.9% of malignant melanoma cases, respectively, while none of clear cell sarcoma harbored BRAF or NRAS mutations. Fluorescence in situ hybridization showed that 78.6% of clear cell sarcoma exhibited the t(12;22)(q13;q12) translocation. The presence of type 1, 2, and 3 EWSR1/ATF1 fusion gene transcripts was confirmed by reverse transcriptase polymerase chain reaction analysis, but type 4 and EWSR1/CREB1 fusion gene transcripts were not found. No fusion transcript could be detected in any of the malignant melanoma cases. Additionally, immunohistochemistry showed that the majority of clear cell sarcoma and malignant melanoma had insulin-like growth factor 2 and insulin-like growth factor receptor 1 expression; however the expression of insulin-like growth factor 1R was significantly higher in clear cell sarcoma compared to melanoma (p = .006). Our results suggest that the combination of BRAF and NRAS mutation analysis with fusion gene detection contributes to diagnosis of malignant melanoma and clear cell sarcoma, and that insulin-like growth factor 1R might be a novel target for the treatment of these two malignancies.
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Affiliation(s)
- Linlin Yang
- Institute of Pathology, University Hospital Jena, Friedrich-Schiller-University Jena, 07743 Jena, Germany
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28
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Feito-Rodríguez M, de Lucas-Laguna R, Bastian BC, Leboit P, González-Beato MJ, López-Gutiérrez JC, Requena L, Pizarro A. Nodular lesions arising in a large congenital melanocytic naevus in a newborn with eruptive disseminated Spitz naevi. Br J Dermatol 2012; 165:1138-42. [PMID: 21711345 DOI: 10.1111/j.1365-2133.2011.10502.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Congenital malignant melanoma within a pre-existing large congenital melanocytic naevus (CMN) is exceedingly rare. Its incidence is difficult to determine due to the small number of reported cases and because of problems associated with diagnosis. Some benign nodular proliferations (called proliferative nodules) arising in CMN, while rare, are significantly more common and can mimic malignant melanoma clinically or histologically. There are no reported cases of congenital melanoma or benign proliferative nodules in CMN in patients who also had eruptive disseminated Spitz naevi. We describe a girl who was noted to have a dark-brown plaque with several large erythematous nodules affecting the scalp at delivery, in addition to multiple erythematous dome-shaped papules that developed in a disseminated manner over several months, beginning at 10 days of age. It was difficult, not only clinically but also histologically, to determine the benign or malignant nature of all of these lesions. As primary cutaneous melanoma, atypical proliferative nodules in CMN, bland CMN or CMN with foci of increased cellularity and Spitz naevi show clear differences in the genetic aberration patterns, comparative genomic hybridization (CGH) could be a diagnostic help in ambiguous cases such as this. CGH performed on this patient showed multiple DNA copy number changes in the most atypical nodule, but such alterations could not be found in the remainder of the lesions. CGH showed differences between the nodular lesions that occurred in the CMN and helped us in supporting the diagnosis of this unique case of benign proliferative nodules and a possible congenital melanoma arising in a large CMN, associated with multiple widespread eruptive Spitz naevi.
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Affiliation(s)
- M Feito-Rodríguez
- Department of Dermatology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, 28046 Madrid, Spain.
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29
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Manganoni AM, Rossi MT, Sala R, Venturini M, Sereni E, Ungari M, Marocolo D, Lonardi S, Calzavara-Pinton P. Dermoscopic, histological and immunohistochemical evaluation of cancerous features in acquired melanocytic nevi that have been repeatedly exposed to UVA or UVB. Exp Dermatol 2011; 21:86-90. [DOI: 10.1111/j.1600-0625.2011.01397.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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BRAF Exon 15 T1799A Mutation Is Common in Melanocytic Nevi, but Less Prevalent in Cutaneous Malignant Melanoma, in Chinese Han. J Invest Dermatol 2011; 131:1129-38. [DOI: 10.1038/jid.2010.405] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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31
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Abstract
Despite recent advances, the biology underlying nevogenesis remains unclear. Activating mutations in NRAS, HRAS, BRAF, and GNAQ have been identified in benign nevi. Their presence roughly correlates with congenital, Spitz, acquired, and blue nevi, respectively. These mutations are likely to play a critical role in driving nevogenesis. While each mutation is able to activate the MAP kinase pathway, they also interact with a host of different proteins in other pathways. The different melanocytic developmental pathways activated by each mutation cause the cells to migrate, proliferate, and differentiate to different extents within the skin. This causes each mutation to give rise to a characteristic growth pattern. The exact location and differentiation state of the cell of origin for benign moles remains to be discovered. Further research is necessary to fully understand nevus development given that most of the same developmental pathways are also present in melanoma.
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32
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Kong Y, Kumar SM, Xu X. Molecular pathogenesis of sporadic melanoma and melanoma-initiating cells. Arch Pathol Lab Med 2011. [PMID: 21128770 DOI: 10.1043/2009-0418-rar.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Recent advances in molecular genetics and cancer stem cell biology have shed some light on the molecular basis of melanomagenesis. In this review, we will focus on major genetic alterations in the melanoma, particularly pathways involved in cell proliferation, apoptosis, and tumor suppression. The potential role of melanoma-initiating cells during melanomagenesis and progression will also be discussed. Understanding pathogenesis of melanoma may uncover new diagnostic clues and therapeutic targets for this increasingly prevalent disease.
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Affiliation(s)
- Yunyi Kong
- Department of Pathology, Cancer Hospital, Fudan University, Shanghai, People’s Republic of China
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33
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Kong Y, Kumar SM, Xu X. Molecular Pathogenesis of Sporadic Melanoma and Melanoma-Initiating Cells. Arch Pathol Lab Med 2010; 134:1740-9. [DOI: 10.5858/2009-0418-rar.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Recent advances in molecular genetics and cancer stem cell biology have shed some light on the molecular basis of melanomagenesis. In this review, we will focus on major genetic alterations in the melanoma, particularly pathways involved in cell proliferation, apoptosis, and tumor suppression. The potential role of melanoma-initiating cells during melanomagenesis and progression will also be discussed. Understanding pathogenesis of melanoma may uncover new diagnostic clues and therapeutic targets for this increasingly prevalent disease.
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34
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Abstract
Melanoma, one of the most aggressive forms of human cancer, has undergone an alarming increase in incidence in recent years. Early detection is a prerequisite for proper diagnosis and therapy orientation. Soluble biomarkers are an important tool for early diagnosis. Markers that are associated with melanocyte functions imply the enzymes involved in melanin synthesis and the melanin-related metabolites. Proteins such as autocrine melanocyte cell growth factor and melanoma metastasis suppressor have gained attention in the biomarkers domain. The antimelanoma immune response elicited in patients can not only provide new biomarkers but important therapeutic approaches in specific treatments. All the molecules generated during the metastasis process, invasion of neighboring tissue, angiogenesis, invading lymphatic/blood vessels and establishing new tumors at a distant site, are targets for biomarker discovery.
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Affiliation(s)
- Monica Neagu
- 'Victor Babes' National Institute of Pathology, Immunology Department, 99-101 Splaiul Independentei, 050096 Bucharest, Romania.
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35
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36
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A mutated EGFR is sufficient to induce malignant melanoma with genetic background-dependent histopathologies. J Invest Dermatol 2010; 130:249-58. [PMID: 19609310 DOI: 10.1038/jid.2009.213] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Melanoma is a tumor with a very low cure rate once metastasized. Although many genes important for melanoma induction, transformation, and metastasis have been identified, the process of melanomagenesis is only partly understood. Melanoma mediators are easiest to investigate in cell culture models, but animal models are required to evaluate their importance in the context of the whole organism. Here, we describe a transgenic melanoma model in medaka. The oncogenic receptor tyrosine kinase, Xmrk, responsible for melanoma formation in Xiphophorus, was stably expressed under the control of a pigment cell-specific promoter. The transgenic fish developed pigment cell tumors with a penetrance of 100%. The model was used for monitoring the in vivo relevance of several apoptosis and differentiation genes, and for induction of melanoma-relevant signal transduction pathways. We found that Stat5 activation, and Mitf and Bcl-2 levels correlated with a more aggressive stage of the malignancy. Interestingly, different types of pigment cell tumors occurred depending on the genetic background, namely invasive melanoma, uveal melanoma, or exophytic and less aggressive pigment cell tumors called xanthoerythrophoroma. Furthermore, on p53 mutant background, the expression of xmrk led to the appearance of giant focal pigment cell tumors, whereas tumor onset was unchanged compared with wild-type medaka.
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37
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Palmieri G, Capone M, Ascierto ML, Gentilcore G, Stroncek DF, Casula M, Sini MC, Palla M, Mozzillo N, Ascierto PA. Main roads to melanoma. J Transl Med 2009; 7:86. [PMID: 19828018 PMCID: PMC2770476 DOI: 10.1186/1479-5876-7-86] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 10/14/2009] [Indexed: 12/12/2022] Open
Abstract
The characterization of the molecular mechanisms involved in development and progression of melanoma could be helpful to identify the molecular profiles underlying aggressiveness, clinical behavior, and response to therapy as well as to better classify the subsets of melanoma patients with different prognosis and/or clinical outcome. Actually, some aspects regarding the main molecular changes responsible for the onset as well as the progression of melanoma toward a more aggressive phenotype have been described. Genes and molecules which control either cell proliferation, apoptosis, or cell senescence have been implicated. Here we provided an overview of the main molecular changes underlying the pathogenesis of melanoma. All evidence clearly indicates the existence of a complex molecular machinery that provides checks and balances in normal melanocytes. Progression from normal melanocytes to malignant metastatic cells in melanoma patients is the result of a combination of down- or up-regulation of various effectors acting on different molecular pathways.
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Affiliation(s)
- Giuseppe Palmieri
- Istituto di Chimica Biomolecolare, Consiglio Nazionale delle Ricerche (CNR), Sassari, Italy.
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38
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Moretti S, De Falco V, Tamburrino A, Barbi F, Tavano M, Avenia N, Santeusanio F, Santoro M, Macchiarulo A, Puxeddu E. Insights into the molecular function of the inactivating mutations of B-Raf involving the DFG motif. BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2009; 1793:1634-45. [PMID: 19735675 DOI: 10.1016/j.bbamcr.2009.09.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2008] [Revised: 08/28/2009] [Accepted: 09/01/2009] [Indexed: 12/19/2022]
Abstract
BRAF gene mutations have been associated with human cancers. Among the naturally occurring mutations, two that involve amino acids of the conserved DFG motif in the activation loop (D594V and G596R), appear to be inactivating. Aim of this study was to analyze the molecular mechanisms involved in the loss of function of B-Raf inactivating mutation G596R. Furthermore, the ability of the B-Raf DFG motif mutants to generate heterodimers with C-Raf and the possible functional consequences of the B-Raf/C-Raf heterodimer formation was examined. Wet molecular experiments in HEK293T cells demonstrate that B-Raf(G596R) is a kinase-impaired mutant. Molecular dynamics simulations show that the loss of function of B-Raf(G596R) depends on a restraining effect of Arg596 on the catalytic residue Asp594, which results in the loss of the appropriate spatial localization and/or conformation of the latter necessary for anchoring ATP to the enzyme. Exploration of B-Raf/C-Raf heterodimer formation indicates the occurrence of functioning heterodimers in the case of all the DFG B-Raf mutants, independently from the expected differences in spatial conformation of the activation loop, although the transforming activity of the mutants appear negligible. In conclusion, this study delivers novel information on the functional properties of the B-Raf DFG motif inactivating mutants and on the mechanisms driving B-Raf/C-Raf heterodimerization and consequent C-Raf transactivation.
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Affiliation(s)
- Sonia Moretti
- Dipartimento di Medicina Interna, Università di Perugia, Perugia, Italy
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39
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Yamaura M, Mitsushita J, Furuta S, Kiniwa Y, Ashida A, Goto Y, Shang WH, Kubodera M, Kato M, Takata M, Saida T, Kamata T. NADPH oxidase 4 contributes to transformation phenotype of melanoma cells by regulating G2-M cell cycle progression. Cancer Res 2009; 69:2647-54. [PMID: 19276355 DOI: 10.1158/0008-5472.can-08-3745] [Citation(s) in RCA: 144] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Generation of reactive oxygen species (ROS) has been implicated in carcinogenic development of melanoma, but the underlying molecular mechanism has not been fully elucidated. We studied the expression and function of the superoxide-generating NADPH oxidase (Nox)4 in human melanoma cells. Nox4 was up-regulated in 13 of 20 melanoma cell lines tested. Silencing of Nox4 expression in melanoma MM-BP cells by small interfering RNAs decreased ROS production and thereby inhibited anchorage-independent cell growth and tumorigenecity in nude mice. Consistently, a general Nox inhibitor, diphenylene iodonium, and antioxidants vitamine E and pyrrolidine dithiocarbamate blocked cell proliferation of MM-BP cells. Flow cytometric analysis indicated that Nox4 small interfering RNAs and diphenylene iodonium induced G(2)-M cell cycle arrest, which was also observed with another melanoma cell line, 928mel. This was accompanied by induction of the Tyr-15 phosphorylated, inactive form of cyclin-dependent kinase 1 (a hallmark of G(2)-M checkpoint) and hyperphosphorylation of cdc25c leading to its increased binding to 14-3-3 proteins. Ectopic expression of catalase, a scavenger of ROS, also caused accumulation of cells in G(2)-M phase. Immunohistochemistry revealed that expression of Nox4 was detected in 31.0% of 13 melanoma patients samples, suggesting the association of Nox4 expression with some steps of melanoma development. The findings suggest that Nox4-generated ROS are required for transformation phenotype of melanoma cells and contribute to melanoma growth through regulation of G(2)-M cell cycle progression.
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Affiliation(s)
- Maki Yamaura
- Department of Dermatology, Shinshu University Graduate School of Medicine, Matsumoto, Nagano, Japan
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Pons M, Mancheño-Corvo P, Martín-Duque P, Quintanilla M. Molecular Biology of Malignant Melanoma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2009; 624:252-64. [DOI: 10.1007/978-0-387-77574-6_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Meleti M, Vescovi P, Mooi WJ, van der Waal I. Pigmented lesions of the oral mucosa and perioral tissues: a flow-chart for the diagnosis and some recommendations for the management. ACTA ACUST UNITED AC 2008; 105:606-16. [PMID: 18206403 DOI: 10.1016/j.tripleo.2007.07.047] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 05/13/2007] [Accepted: 07/30/2007] [Indexed: 12/15/2022]
Abstract
The term "pigmentation of the oral mucosa" is applied to a wide range of lesions or conditions featuring a change of color of oral tissues. Lesions not associated with an accumulation of pigment (e.g., Fordyce spots) are usually not classified as pigmented lesions. Two groups of pigmented lesions of the oral mucosa are recognized: 1) melanin-associated lesions, including racial pigmentations, melanotic macules, melanocytic nevi, and malignant melanoma; and 2) nonmelanin-associated lesions (e.g., blood-related pigmentations, metallic pigmentations). This paper presents a clinicopathologic review of the recent literature with emphasis on the main diagnostic features, including the use of immunohistochemical markers. A flow-chart is added that may help the clinician in the diagnosis and management of these lesions.
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Affiliation(s)
- Marco Meleti
- Unit of Oral Pathology and Medicine, Section of Odontostomatology, Department of ENT, Dental, Ophthalmological, and Cervicofacial Sciences, University of Parma, Parma, Italy
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42
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Meleti M, Mooi WJ, Casparie MK, van der Waal I. Melanocytic nevi of the oral mucosa – No evidence of increased risk for oral malignant melanoma: An analysis of 119 cases. Oral Oncol 2007; 43:976-81. [PMID: 17258496 DOI: 10.1016/j.oraloncology.2006.11.013] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2006] [Revised: 11/10/2006] [Accepted: 11/10/2006] [Indexed: 11/19/2022]
Abstract
Pigmented nevi of the oral mucosa are rare benign melanocytic tumours. Epidemiological data are scanty, and the etiology and pathogenesis of these lesions are poorly understood. Reports are mainly based on isolated cases or a relatively small series of cases. Some reviews have drawn attention to the frequent localization of these lesions on the hard palate, the site of preference for oral malignant melanoma (OMM). However, as yet, there is no direct proof that oral melanocytic nevi (OMNs) constitute precursor lesions of OMM. 119 cases of OMNs, registered at the nationwide Registry of Pathology (PALGA) in The Netherlands during the period 1980-2005, have been evaluated. Subepithelial OMNs were the most commonly recorded lesions (96 cases), followed by blue (10 cases), compound (7 cases) and junctional OMNs (5 cases). Only one case of a combined nevus was recorded. None of the patients developed OMM during a mean follow-up period of 8.6years. We present an analysis of this series of cases, together with a review of the literature. The findings of the present evaluation do not give support for the hypothesis of OMN being a marker for an increased risk of future development of OMM.
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Affiliation(s)
- Marco Meleti
- Unit of Oral Pathology and Medicine, Section of Odontostomatology, Department of ENT/Dental/Ophthalmological and Cervico-Facial Sciences, University of Parma, Italy.
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43
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Mentzel T. [Diagnosis of melanocytic tumours : Old and new problems with an increasingly common tumour group]. DER PATHOLOGE 2007; 28:401-2. [PMID: 17882421 DOI: 10.1007/s00292-007-0943-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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44
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Takata M, Lin J, Takayanagi S, Suzuki T, Ansai S, Kimura T, Cerroni L, Saida T. Genetic and epigenetic alterations in the differential diagnosis of malignant melanoma and spitzoid lesion. Br J Dermatol 2007; 156:1287-94. [PMID: 17535228 DOI: 10.1111/j.1365-2133.2007.07924.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The histopathological differentiation of malignant melanoma and Spitz naevus often presents diagnostic problems. OBJECTIVES We aimed to find out applicable diagnostic parameters other than routine pathology. METHODS The cases included conventional melanomas and Spitz naevi as well as atypical spitzoid lesions that had posed diagnostic difficulties. We examined hotspots of mutation in the BRAF, NRAS and HRAS genes by polymerase chain reaction-based direct sequencing. We also analysed DNA copy number aberrations and the methylation of CpG sequences in several cancer-related genes by utilizing a novel methylation-specific multiplex ligation-dependent probe amplification method. RESULTS Twenty three of 24 conventional melanomas showed at least one of the genetic and epigenetic alterations examined, although one acral melanoma did not show any alteration. By sharp contrast, 12 Spitz naevi with an unambiguous histopathology showed no or few chromosomal aberrations, no oncogene mutations and no methylation of CpG sequences. Of the 16 ambiguous spitzoid lesions, most of which were designated atypical Spitz tumour by one of the authors, all but one showed no mutations, no methylations and few copy number aberrations. However, three tumours showed copy number loss of the cyclin-dependent kinase inhibitor 2A gene (CDKN2A), an alteration observed frequently in melanomas but not found in conventional Spitz naevi. These results show that, although most atypical Spitz tumours do not differ from conventional Spitz naevi showing virtually no genetic and epigenetic aberrations, some cases may have chromosomal aberrations that include copy number loss of the CDKN2A gene. CONCLUSIONS Genetic and epigenetic analyses may be useful as an additional diagnostic tool to distinguish between melanoma and Spitz naevus, and may help to define subgroups in atypical Spitz tumours.
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Affiliation(s)
- M Takata
- Department of Dermatology, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Japan.
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