Kuk Su Kyung, Won Chong Hyun, Lee Woo Jin, Shin Wui Jung, Yoon Hye Jung, Hong Seong Doo, Hong Sam Pyo, Lee Jae
aDepartment of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University bDepartment of Dermatology, Asan Medical Center, Seoul, Republic of Korea.
Melanoma Res. 2016 Oct;26(5):457-63. doi: 10.1097/CMR.0000000000000265.
Several studies have examined the correlation between nestin expression and the degree of tumor invasion in cutaneous melanoma. However, no information has been reported on nestin in primary mucosal melanoma of the head and neck. The present study examined the expression and prognostic significance of nestin in patients with primary mucosal melanoma of the oral cavity. Nestin expression was examined immunohistochemically in 39 patients (six oral melanoma in-situ cases and 33 invasive oral melanoma cases) and analyzed for association with disease progression. Age, sex, anatomic site, stage, level of invasion, regional lymph node metastasis, surgical margin involvement, and treatment modality were also analyzed. In the 33 invasive melanoma cases, invasion depth correlated significantly with prognosis in univariate and multivariate analyses. High-intensity nestin staining was observed in 14 of the 33 cases and a high proportion of nestin-positive cells was observed in 16 cases. In stage III oral melanoma cases, nestin expression was not significantly associated with disease progression. However, in stage IV cases, both the intensity and the proportion of nestin expression were significantly associated with disease progression (P=0.022 and 0.005, respectively). In all 33 invasive cases, multivariate analyses showed that both the intensity and the proportion of nestin were significantly associated with a poor prognosis (P=0.014 and 0.009; hazard ratio, 3.59 and 4.05; 95% confidence interval, 1.29-9.98 and 1.42-11.56, respectively). In conclusion, nestin can be a valuable prognostic indicator in the advanced-stage (stage IV) cases of oral mucosal melanoma.
多项研究探讨了巢蛋白表达与皮肤黑色素瘤肿瘤侵袭程度之间的相关性。然而，关于头颈部原发性黏膜黑色素瘤中巢蛋白的情况尚无相关报道。本研究检测了巢蛋白在口腔原发性黏膜黑色素瘤患者中的表达及其预后意义。对39例患者（6例口腔原位黑色素瘤病例和33例侵袭性口腔黑色素瘤病例）进行免疫组织化学检测巢蛋白表达，并分析其与疾病进展的关系。同时还分析了年龄、性别、解剖部位、分期、侵袭水平、区域淋巴结转移、手术切缘受累情况及治疗方式。在33例侵袭性黑色素瘤病例中，单因素和多因素分析显示侵袭深度与预后显著相关。33例病例中有14例观察到高强度巢蛋白染色，16例观察到高比例的巢蛋白阳性细胞。在III期口腔黑色素瘤病例中，巢蛋白表达与疾病进展无显著相关性。然而，在IV期病例中，巢蛋白表达的强度和比例均与疾病进展显著相关（分别为P = 0.022和0.005）。在所有33例侵袭性病例中，多因素分析显示巢蛋白的强度和比例均与预后不良显著相关（P = 0.014和0.009；风险比分别为3.59和4.05；95%置信区间分别为1.29 - 9.98和1.42 - 11.56）。总之，巢蛋白可作为晚期（IV期）口腔黏膜黑色素瘤病例的一个有价值的预后指标。
