Munhoz de Paula Alves Coelho Karina, Stall Jaqueline, Fronza Júnior Hercílio, Blasius Rodrigo, de França Paulo Henrique Condeixa
Universidade da Região de Joinville - UNIVILLE, Paulo Malschitzki St, 10, 89219-710, Joinville, Santa Catarina, Brazil; Centro de Diagnósticos Anátomo-Patológicos - CEDAP, Mario Lobo St, 61, 89201-330, Joinville, Santa Catarina, Brazil.
Universidade da Região de Joinville - UNIVILLE, Paulo Malschitzki St, 10, 89219-710, Joinville, Santa Catarina, Brazil; Centro de Diagnósticos Anátomo-Patológicos - CEDAP, Mario Lobo St, 61, 89201-330, Joinville, Santa Catarina, Brazil.
Pathol Res Pract. 2017 Sep;213(9):1067-1071. doi: 10.1016/j.prp.2017.07.028. Epub 2017 Aug 1.
Malignant melanoma is an aggressive disease and its incidence is increasing worldwide. Genetic predisposition and exposure to environmental factors, especially sunlight, are risk factors. Histopathologic distinction between nevi and melanomas can be difficult. It is anticipated that the evaluation of the immunohistochemical expression of some genes could contribute to the differential diagnosis of questionable histologically lesions. The objective of this study was to investigate wether the evaluation of the immunohistochemical expression of genes CADM1, TWIST1 and CDH1 (E-cadherin), that take part in mechanisms of cell adhesion and epithelial-mesenchymal transition, contributes to the differential diagnosis of melanocytic lesions difficult to diagnose.
Retrospective cross-sectional study based on immunohistochemistry analysis of samples of 30 dysplastic compound melanocytic nevi, 30 melanomas less than 1.0mm thick and 30 melanomas more than 1.0mm thick, diagnosed between 2013 and 2016. A score was used to evaluate color intensity and percentage of cells stained.
There were significant reductions in the expression of the genes CADM1 and CDH1 in melanomas (below and above 1.00mm of thickness) and in melanomas more than 1.0mm thick, respectively, compared to dysplastic compund melanocytic nevi. There was also lower expression of the genes CADM1 and CDH1 in melanomas greater than 1.0mm thick compared to melanomas less than 1.0mm. The gene TWIST1 showed no significant difference in expression between groups.
These findings allow us to conclude that the immunohistochemical expression of CADM1 has the potential to contribute as an auxiliary tool to the differential diagnosis between nevi and melanomas.
恶性黑色素瘤是一种侵袭性疾病,其在全球的发病率正在上升。遗传易感性和暴露于环境因素,尤其是阳光,是风险因素。痣和黑色素瘤之间的组织病理学区分可能很困难。预计对某些基因免疫组化表达的评估有助于对组织学上有疑问的病变进行鉴别诊断。本研究的目的是调查参与细胞黏附及上皮-间质转化机制的CADM1、TWIST1和CDH1(E-钙黏蛋白)基因免疫组化表达的评估是否有助于对难以诊断的黑素细胞病变进行鉴别诊断。
基于对2013年至2016年间诊断的30例发育异常复合性黑素细胞痣、30例厚度小于1.0mm的黑色素瘤和30例厚度大于1.0mm的黑色素瘤样本进行免疫组化分析的回顾性横断面研究。使用评分来评估染色强度和染色细胞百分比。
与发育异常复合性黑素细胞痣相比,厚度低于和高于1.00mm的黑色素瘤以及厚度大于1.0mm的黑色素瘤中,CADM1和CDH1基因的表达分别显著降低。与厚度小于1.0mm的黑色素瘤相比,厚度大于1.0mm的黑色素瘤中CADM1和CDH1基因的表达也较低。TWIST1基因在各组之间的表达没有显著差异。
这些发现使我们能够得出结论,CADM1的免疫组化表达有可能作为一种辅助工具,有助于痣和黑色素瘤之间的鉴别诊断。