Prognostic value of selected immunohistochemical markers in skin melanoma

A i m: to assess the significance of the expression of metalloproteinase 2 (MMP-2), CD44 glycoprotein and nm23 diphosphate nucleoside kinase on melanoma progression and survival time and its comparison with the influence of clinical and histopathological parameters. M a t e r i a l a n d m e t o d s: 39 patients operated for the first time because of melanoma in the 2nd Department of Oncological Surgery of the Greatpoland Cancer Centre in Poznan between the years 1990-1994. Clinical data such as age, gender, the occurrence of cancer spread, its location and survival time were assessed. Using archival histopathological specimens we assessed the thickness of tumour invasion in mm according to Breslow, the level of invasion according to Clark, histological type, the presence of lymphocyte infiltration, regression symptoms, the existence of preexisting naevus, the presence of ulceration, the presence of satellites and metastases to lymphatic nodes. Immunohistochemical marker expression was performed in tissue material obtained from archival paraffin blocks. The presence of HMB-45 and PCNA, the expression of metalloproteinase 2 (MMP-2), CD44 glycoprotein and nm23 diphosphate nucleoside kinase were also assessed. Clinical, histopathological and immunohistochemical data was analysed in correlation with survival time. The evaluation of prognostic factors was performed by Cox’s nonparametric proportional hazard regression model. R e s u l t s: the crucial prognostic factor in the examined group turned out to be the presence of a positive reaction product at the site of nm23 diphosphate nucleoside kinase existence in correlation with both clinical and histological factors. In the growup of pathological factors the prognostic significance of the lymphatic metastases at the onset of treatment was demonstrated. C o n c l u s i o n s: the results indicate that the greatest prognostic value of skin melanoma progression lies in the demonstration of nm23 diphosphate nucleoside kinase in skin.

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