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Immunohistochemical analysis of Bcl-2, nuclear S100A4, MITF and Ki67 for risk stratification of early-stage melanoma - a combined IHC score for melanoma risk stratification

Item Type:Article
Title:Immunohistochemical analysis of Bcl-2, nuclear S100A4, MITF and Ki67 for risk stratification of early-stage melanoma - a combined IHC score for melanoma risk stratification
Creators Name:Jurmeister, P. and Bockmayr, M. and Treese, C. and Stein, U. and Lenze, D. and Jöhrens, K. and Friedling, F. and Dietel, M. and Klauschen, F. and Marsch, W. and Fiedler, E. and von Laffert, M.
Abstract:BACKGROUND AND OBJECTIVES: Overall survival (OS) in patients with early-stage malignant melanoma differs. To date, there are no established prognostic markers. We aimed to contribute to a better understanding of potential prognostic immunohistochemical markers for risk stratification. PATIENTS AND METHODS: 161 surgically resected early-stage malignant melanomas (stage pT1 and pT2) were analyzed for expression of 20 different proteins using immunohistochemistry. The results were correlated with OS. The cohort was randomly split into a discovery and a validation cohort. RESULTS: High Bcl-2 expression, high nuclear S100A4 expression as well as a Ki67 proliferation index of ≥ 20 % were associated with shorter OS. Strong MITF immunoreactivity was a predictor for favorable prognosis. A combination of these four markers resulted in a multi-marker score with significant prognostic value in multivariate survival analysis (HR: 3.704; 95 % CI 1.484 to 9.246; p = 0.005). Furthermore, the score was able to differentiate a low-risk group with excellent OS rates (five-year survival rate: 100 %), an intermediate-risk group (five-year survival rate: 81.8 %) and a high-risk group (five-year survival rate: 52.6 %). The prognostic value was confirmed within the validation cohort. CONCLUSIONS: Combined immunohistochemical analysis of Bcl-2, nuclear S100A4, Ki67 and MITF could contribute to better risk stratification of early-stage malignant melanoma patients.
Source:Journal der Deutschen Dermatologischen Gesellschaft
ISSN:1610-0379
Publisher:Wiley (Germany)
Volume:17
Number:8
Page Range:800-808
Date:August 2019
Official Publication:https://doi.org/10.1111/ddg.13917
PubMed:View item in PubMed
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https://edoc.mdc-berlin.de/18397/German version

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