nm23 expression in primary cutaneous malignant melanomas

Abstract

Background and Design: We investigated the correlation between nm23 and tumor depth in primary cutaneous malignant melanomas (PCMM). Materials and Methods: Sixteen cases in sun-exposed areas and 10 cases in nonexposed areas were included into the study. Clark Levels (CL) were determined to evaluate tumor depth. Immunohistochemically more than 10% of cytoplasmic staining by nm23 was assessed in a semiguantitative fashion. The extent of staining was estimated as (+), (++), (+++), the intensity of staining was graded as (+), (++), (+++). Results: There were totally 6 PCMM cases with low Clark level (CL I, II, III). The extent of nm23 staining was as follows: in 4 cases (+++), in 1 case (++) and in 1 case (+). The intensity of staining was in 5 cases (+++), in 1 case (++). There were 20 PCMM cases with high CL (CL IV, V). The extent of nm23 staining was as follows; in 15 cases (+++), in 2 cases (++), there was no staining in 3 cases. The intensity of staining was (+++) in 6 cases, (+) in 5 cases, (-) in 3 cases. No significant difference regarding the nm 23 positivity was observed in PCMM in sun exposed areas and nonexposed areas. Conclusion: In all of the cases with low CL there was nm23 staining. This finding suggests tumor suppressor potential of nm23. But the number of cases with high CL that weren't stained by nm23 was fewer on the contrary of the expected. We thought that nm23 expression may not be related to the depth of tumor invasion. Besides the fewer expression of the nm23 in PKMM in sun exposed areas may suggest the more aggressive behavior in those tumors.

Özet

Primer kutanöz malin melanomlarda (PKMM) nm23 ekspresyonu ile tümör derinliği arasında ilişki olup olmadığını araştırmak üzere çalışmaya 16 sı güneş gören 10 u güneş görmeyen alanda saptanan 26 PKMM olgusu incelendi. Tümör derinliği Clark Level (CL) ile belirlendi, immünhistokimyasal olarak nm23 ile tümör hücrelerinde %10 dan fazla sitoplazmik boyanma semikantitatif olarak yaygınlık (+,++,+++) ve yoğunluğuna (+,++,+++) göre değerlendirildi. CL ı düşük olan (CL I, II, III) toplam 6 PKMM olgusunda; nm23 boyanma yaygınlığı 4 olguda (+++), 1 olguda (++), 1 olguda (+) idi, boyanma yoğunluğu ise 5 olguda (+++), 1 olguda (++) idi. CL ı yüksek olan (CL IV, V) toplam 20 PKMM olgusu vardı. nm23 boyanma yaygınlığı 15 olguda (+++), 2 olguda (++) iken, 3 olguda boyanma gözlenmedi. Boyanma yoğunluğu 6 olguda (+++), 6 olguda (++), 5 olguda (+), 3 olguda (-) idi. Güneş gören ve görmeyen alanlardaki PKMM larda nm23 pozitivitesinde anlamlı fark saptanmadı. CL ı düşük olguların tamamında nm23 ile boyanma izlenmesi nm23 ün tümör süpresör etkisini düşündürmektedir ancak CL ı yüksek olguların beklenenin aksine, nispeten daha azında boyanma olmaması nm23 ekspresyonunun tümör invazyon derinliğiyle ilişkili olmayabileceğini akla getirmektedir. Ayrıca güneş gören alanlarda CL ı yüksek PKMM olgularında nm23 ekspresyonunun daha az bulunması, bu alanlarda görülen PKMM lann daha agresif olabileceğini düşündürmüştür.