Biologic and prognostic significance of dermal Ki67 expression, mitoses, and tumorigenicity in thin invasive cutaneous melanoma
| Autor: | David E. Elder, Todd Murry, Phyllis A. Gimotty, DuPont Guerry, Michael E. Ming, Xiaowei Xu, Kathleen T. Montone, Patricia Van Belle, Susan Hotz, Shane R. Raines, Peter Wahl |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Cancer Research Pathology medicine.medical_specialty Mitotic index Skin Neoplasms Cohort Studies Lymphocytes Tumor-Infiltrating Mitotic Index Medicine Humans Prospective Studies Prospective cohort study Survival rate Melanoma Aged Cell Proliferation Aged 80 and over business.industry Cell growth Proportional hazards model Middle Aged medicine.disease Prognosis Survival Rate Ki-67 Antigen Oncology Cutaneous melanoma Immunohistochemistry Female business |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 23(31) |
| ISSN: | 0732-183X |
| Popis: | PurposeTumor cell proliferation is a central feature of melanoma progression. In this study, we characterized three biomarkers of proliferation (Ki67 expression, dermal mitotic rate [MR], and tumorigenicity) in thin (≤ 1.00 mm) primary cutaneous melanomas and examined their association with prognosis.Patients and MethodsWe used immunohistochemistry to determine Ki67 expression using the monoclonal antibody MIB-1 in lesions from a prospective cohort that included 396 patients with thin invasive primary melanomas seen between 1972 and 1991. A multivariate Cox proportional hazards model was used to define independent prognostic factors, and recursive partitioning was used to develop a prognostic tree identifying risk groups.ResultsDermal Ki67 expression was lower than epidermal Ki67 expression in radial growth phase (RGP) melanomas (n = 171), and dermal Ki67 expression and MR were higher in tumorigenic vertical growth phase (VGP) melanomas (n = 193) compared with RGP and nontumorigenic VGP melanomas (n = 42). Dermal Ki67 expression, MR greater than 0, growth phase, thickness, ulceration, tumor-infiltrating lymphocytes, and sex were associated with metastasis at 10 years, however, only dermal Ki67 expression, MR greater than 0, and sex were independent prognostic factors. Two high-risk groups were identified: men and women with dermal MR greater than 0 and dermal Ki67 expression ≥ 20% in tumor cells and men with MR greater than 0 and Ki67 expression less than 20%, with 10-year metastasis rates of 39% and 20%, respectively.ConclusionProliferation slows as melanoma cells enter the dermis and then increases with the onset of tumorigenic VGP. Ki67 expression and dermal MR provide independent prognostic information that can potentially be used in risk-based management of patients. |
| Databáze: | OpenAIRE |
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