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| 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., Bockmayr, M., Treese, C., Stein, U., Lenze, D., Jöhrens, K., Friedling, F., Dietel, M., Klauschen, F., Marsch, W., 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. |
| Keywords: | Immunohistochemistry, Ki-67 Antigen, Melanoma, Microphthalmia-Associated Transcription Factor, Mitotic Index, Neoplasm Staging, Prognosis, Proto-Oncogene Proteins c-bcl-2, Risk Assessment, Risk Factors, S100 Calcium-Binding Protein A4, Skin Neoplasms, Tumor Biomarkers |
| Source: | Journal der Deutschen Dermatologischen Gesellschaft |
| ISSN: | 1610-0379 |
| Publisher: | Wiley |
| 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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