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中国人黑素细胞肿瘤的C-kit表达及其与临床病理参数和解剖部位的关系

C-kit expression of melanocytic neoplasm and association with clinicopathological parameters and anatomic locations in Chinese people.

作者信息

Lin Yu-Chieh, Chang Yi-Ming, Ho Jar-Yi, Lin Hsin-Chung, Tsai Yuan-Ming, Chiang Chien-Ping, Wang Wei-Ming, Gao Hong-Wei

机构信息

Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Am J Dermatopathol. 2013 Jul;35(5):569-75. doi: 10.1097/DAD.0b013e318279566a.

Abstract

Distinct genetic aberrations between melanomas in different anatomical locations have been confirmed in recent years. However, the associations between immunohistochemical expression, tumor sites, and clinical parameters are not clear. We examined the correlation of protein expression and gene mutation of c-kit with clinicopathological parameters and lesion locations in patients with malignant melanoma (MM). We collected 170 melanocytic lesions, including 106 cutaneous MM from acral melanoma (AM) and nonacral melanoma (NAM) sites, 24 dysplastic nevi, and 40 common melanocytic nevi. Tissue microarray was constructed, and immunohistochemical expression for c-kit was assessed with correlation with clinical parameters. Mutation in exons 11, 13, 17, and 18 of KIT gene in genomic DNA by polymerase chain reaction sequencing was also analyzed. Immunostaining scores for c-kit were found to be statistically higher in Dysplastic Nevi than in common melanocytic nevi and MM. In addition, cytoplasmic c-kit staining was significantly correlated with poor survival in patients with AM but not in those with NAM. Twenty-nine cases of MM (including 9 NAM and 20 AM) are analyzed for mutation in exons 11, 13, 17, and 18 of KIT gene in genomic DNA by polymerase chain reaction sequencing, and no genetic mutation is found. Our findings confirm that KIT mutations, in contrast to previous white cohorts, are not common in both AM and NAM of the Chinese and do not necessarily correlate with c-kit expression. The significantly different association between the expression of c-kit immunoreactivities and the mortality risks of melanomas on acral versus nonacral sites might change site-specific targeted therapeutic concepts in melanoma in the future.

摘要

近年来已证实不同解剖部位的黑色素瘤存在明显的基因畸变。然而,免疫组化表达、肿瘤部位与临床参数之间的关联尚不清楚。我们研究了恶性黑色素瘤(MM)患者中c-kit蛋白表达和基因突变与临床病理参数及病变部位的相关性。我们收集了170个黑素细胞病变,包括106例来自肢端黑色素瘤(AM)和非肢端黑色素瘤(NAM)部位的皮肤MM、24例发育异常痣和40例普通黑素细胞痣。构建组织芯片,并评估c-kit的免疫组化表达与临床参数的相关性。还通过聚合酶链反应测序分析了基因组DNA中KIT基因第11、13、17和18外显子的突变情况。发现发育异常痣中c-kit的免疫染色评分在统计学上高于普通黑素细胞痣和MM。此外,c-kit的细胞质染色与AM患者的不良生存显著相关,而与NAM患者无关。通过聚合酶链反应测序分析了29例MM(包括9例NAM和20例AM)基因组DNA中KIT基因第11、13、17和18外显子的突变情况,未发现基因突变。我们的研究结果证实,与之前的白种人群队列不同KIT突变在中国的AM和NAM中均不常见,且不一定与c-kit表达相关。c-kit免疫反应性表达与肢端和非肢端部位黑色素瘤死亡风险之间显著不同的关联可能会在未来改变黑色素瘤的位点特异性靶向治疗观念。

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