Seregard S, Oskarsson M, Spângberg B
Ophthalmic Pathology and Oncology Service, St Eriks Eye Hospital, Polhemsgatan 50, Stockholm, SE-112 82, Sweden.
Exp Eye Res. 1999 Dec;69(6):671-6. doi: 10.1006/exer.1999.0746.
Loss of nm23 gene expression is believed to enhance metastatic spread in diverse human tumors, including skin melanoma. The purpose of this work was to determine the pattern and prognostic relevance of nm23 protein immunoexpression in conjunctival melanoma and potential precursor lesion. Formaldehyde-fixed, paraffin-embedded conjunctival specimens comprising 85 melanocytic lesions (nevi, primary aquired melanosis with and without atypia and primary and locally recurrent malignant melanomas) from 73 patients were used. Sections from all specimens were examined by light microscopy to assess diverse prognostic parameters. Additional sections were then immunostained for nm23 H-1 protein and the immunoreactivity was assessed semi-quantitatively. Survival data for all patients were retrieved from the National Causes of Death Registry of Sweden.Nm23 H-1 protein was differentially expressed in conjunctival melanocytic lesions, however loss of immunoexpression was not more common in melanocytic lesions asociated with a high risk of malignant transformation. Also, primary and recurrent conjunctival melanomas showed an essentially similar nm23 expression pattern and we could not associate the pattern of nm23 immunoexpression with an increased risk for malignant transformation or locally recurrent disease. While there was a tentative separation between cause-specific survival curves after excision for low and high nm23 expression conjunctival melanoma, there was no statistically significant association with metastatic death of patients. However, loss of nm23 protein immunoexpression may still be of some importance as a marker for prognosis in conjunctival melanoma because the present study could only detect large differences in survival. Our results suggest that any potential prognostic value of nm23 immunoexpression would be independent of other markers, underlining the importance of further studies.
据信，nm23基因表达缺失会增强包括皮肤黑色素瘤在内的多种人类肿瘤的转移扩散。本研究的目的是确定nm23蛋白免疫表达在结膜黑色素瘤及其潜在前驱病变中的模式和预后相关性。使用了来自73例患者的85个黑素细胞病变（痣、有或无异型性的原发性后天性黑素沉着以及原发性和局部复发性恶性黑色素瘤）的甲醛固定、石蜡包埋结膜标本。对所有标本的切片进行光学显微镜检查以评估各种预后参数。然后对额外的切片进行nm23 H-1蛋白免疫染色，并对免疫反应性进行半定量评估。所有患者的生存数据均从瑞典国家死亡原因登记处获取。nm23 H-1蛋白在结膜黑素细胞病变中存在差异表达，然而在与恶性转化高风险相关的黑素细胞病变中，免疫表达缺失并不更常见。此外，原发性和复发性结膜黑色素瘤显示出基本相似的nm23表达模式，并且我们无法将nm23免疫表达模式与恶性转化或局部复发性疾病风险增加相关联。虽然低nm23表达和高nm23表达的结膜黑色素瘤切除术后的特定病因生存曲线之间存在初步分离，但与患者的转移死亡没有统计学上的显著关联。然而，nm23蛋白免疫表达缺失作为结膜黑色素瘤预后的标志物可能仍具有一定重要性，因为本研究只能检测到生存方面的较大差异。我们的结果表明，nm23免疫表达的任何潜在预后价值将独立于其他标志物，这突出了进一步研究的重要性。
