Göde Sercan, Turhal Göksel, Tarhan Ceyda, Yaman Banu, Kandiloğlu Gülşen, Öztürk Kerem, Kaya İsa, Midilli Raşit, Karcı Bülent
Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey.
Department of Patology, Ege University School of Medicine, İzmir, Turkey.
Balkan Med J. 2017 May 5;34(3):255-262. doi: 10.4274/balkanmedj.2016.0503. Epub 2017 Apr 6.
Mucosal melanoma is a rare malignancy arising from melanocytes of the mucosal surfaces. The pattern and frequency of oncogenic mutations and histopathological biomarkers have a role on distinct tumour behaviour and survival.
To assess the rate of C-KIT positivity and its effect on survival of surgically treated sinonasal malignant melanoma patients with other histopathological biomarkers and clinical features.
Retrospective cross-sectional study.
Seventeen sinonasal malignant melanoma patients with a mean age of 65.41 (39-86) years were included. Overall survival and disease-specific survival rates were calculated. The impact of age, gender, stage and extent of the disease, type of surgery, and adjuvant therapies were also taken into consideration. The effect of mitotic index, pigmentation, S100, HMB-45, Melan-A and C-KIT on survival were evaluated.
Median tumour size was 20 mm (interquartile range=27.5 mm). Pigmentation was present in 7 (41.2%) cases. Median number of mitoses per millimetre squared was 11 (interquartile range=13). Melan A was positive in 7 (41.2%) patients, ulceration was present in 6 cases (35.3%), and necrosis was present in (47.1%) 8 cases. Six patients (35.3%) were positive for S100, 14 (82.4%) specimens stained positive for HMB-45 and C-KIT (CD117) was positive in 9 cases (52.9%). Three patients (16.7%) developed distant metastasis. Five year overall and disease free survival rates were 61.4% and 43.8%, respectively.
Although C-KIT positive sinonasal malignant melanoma patients (52.9%) can be candidates for targeted tumour therapies, the studied clinical or histopathological features along with C-KIT seem to have no significant effect on survival in a small group of patients with sinonasal malignant melanoma.
黏膜黑色素瘤是一种起源于黏膜表面黑素细胞的罕见恶性肿瘤。致癌突变和组织病理学生物标志物的模式及频率对不同的肿瘤行为和生存情况有影响。
评估C-KIT阳性率及其对接受手术治疗的鼻窦恶性黑色素瘤患者生存情况的影响，并分析其他组织病理学生物标志物和临床特征。
回顾性横断面研究。
纳入17例鼻窦恶性黑色素瘤患者，平均年龄65.41（39 - 86）岁。计算总生存率和疾病特异性生存率。同时考虑年龄、性别、疾病分期和范围、手术类型及辅助治疗的影响。评估有丝分裂指数、色素沉着、S100、HMB - 45、Melan - A和C - KIT对生存的影响。
肿瘤中位大小为20 mm（四分位间距 = 27.5 mm）。7例（41.2%）有色素沉着。每平方毫米有丝分裂的中位数为11（四分位间距 = 13）。7例（41.2%）患者Melan A呈阳性，6例（35.3%）有溃疡，8例（47.1%）有坏死。6例（35.3%）患者S100呈阳性，14例（82.4%）标本HMB - 45染色呈阳性，9例（52.9%）C - KIT（CD117）呈阳性。3例（16.7%）发生远处转移。5年总生存率和无病生存率分别为61.4%和43.8%。
虽然C - KIT阳性的鼻窦恶性黑色素瘤患者（52.9%）可能是靶向肿瘤治疗的候选者，但在一小群鼻窦恶性黑色素瘤患者中，所研究的临床或组织病理学特征以及C - KIT似乎对生存没有显著影响。
