Proliferative activity of primary cutaneous melanocytic tumours.

The expression of proliferating cell nuclear antigen (PCNA) was examined in formalin-fixed paraffin-embedded tissue sections from 41 lesions (27 melanocytic nevi, 3 atypical nevi and 11 malignant melanomas) to determine the proliferative activity of primary cutaneous melanocytic tumours. Most of the malignant melanomas had more than 7% PCNA-positive cells (9.2 +/- 0.5%), while the melanocytic nevi manifested less than 1% PCNA-positive cells (0.4 +/- 0.1%). Atypical nevi exhibited an intermediate, but still significantly lower, labelling ratio when compared with malignant melanomas (0.8 +/- 0.2%). The proliferative activity of the lesions was compared between portions at different depths in the skin (epidermal, upper dermal and lower dermal location). In cases of malignant melanoma, the proliferative activity was higher in the deeper portion of dermis whereas PCNA-positive cells in melanocytic nevi were located in the upper dermis predominantly. Thus the PCNA labelling ratio of malignant melanoma and/or melanocytic nevus cells located in the epidermodermal junction was not necessarily higher than that of malignant melanoma and/or melanocytic nevus cells in the dermis. These results indicate that staining with PCNA would be very useful in the differentiation of malignant melanoma from melanocytic nevi manifesting cellular and/or structural atypia by virtue of a significant difference in the proportion of PCNA-positive cells. Although malignant melanomas have higher proliferative activity than melanocytic nevi in the deeper dermis, junctional activity in melanocytic tumours does not indicate cell proliferation.