Clinical and histopathological features and immunoreactivity of human choroidal and ciliary melanomas as prognostic factors for metastasis and death.
Clinical and histopathological features and immunoreactivity of human choroidal and ciliary melanomas as prognostic factors for metastasis and death.
复制标题
人类脉络膜和睫状体黑色素瘤的临床和组织病理学特征以及免疫反应性作为转移和死亡的预后因素。
DOI：
10.1007/s00417-011-1769-7
复制
发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Augsburger,JamesJ
中科院分区：
文献类型：
--
作者：
Simões,CamilaC;Call,MindyK;Corrêa,ZéliaM;Spaulding,AbbotG;Augsburger,JamesJ
目的确定骨桥蛋白、波形蛋白、角蛋白8/18、LZTS 1和β-连环蛋白免疫组化反应性与原发性葡萄膜黑色素瘤存档标本中转移和死亡的临床和组织病理学预后因素之间的关系，以及评估的研究变量对转移死亡的预后价值。1999年5月1日至2009年6月30日期间接受摘除术治疗的原发性葡萄膜黑色素瘤的石蜡包埋切片。每个肿瘤的免疫荧光染色进行了评估后，新制备的组织切片上的抗体直接对葡萄膜melanoma.ResultsAfter排除不良预后相关的5个生物标志物，我们的研究组包括82例。在40.2%的角蛋白评价标本、50.0%的骨桥蛋白评价标本、26.8%的β-连环蛋白评价标本、65.9%的波形蛋白评价标本和70.7%的LZTS 1评价标本中观察到免疫荧光。通过有效的随访，27例（32.9%）患者死于确诊或疑似转移性葡萄膜黑色素瘤。肿瘤对β-catenin呈强免疫反应性的患者无一例死于转移。相比之下，肿瘤对LZTS 1表现出任何强度的免疫反应性的患者更容易发生转移。在多变量考克斯比例风险模型中，考虑到β-连环蛋白和LZTS 1免疫染色的复合变量与患者的生存时间具有统计学显着关系。结论我们的研究表明，传统的临床和组织病理学预后因素以及β-连环蛋白和LZTS 1的免疫表达相结合可能比单独的临床和组织形态学因素更好地预测转移。
PurposesTo determine the relationship between immunohistochemical reactivity to osteopontin, vimentin, keratin 8/18, LZTS1, and beta-catenin and clinical and histopathological prognostic factors for metastasis and death in archival specimens of primary uveal melanomas, and the prognostic value of the evaluated study variables for death from metastasis.MethodsRetrospective analysis of clinical records and formalin-fixed, paraffin-embedded slides of primary uveal melanomas treated by enucleation during May 1 1999, through June 30 2009. Immunofluorescent staining of each tumor was assessed on newly prepared histologic slides after the application of antibodies directed against five biomarkers associated with unfavorable prognosis in uveal melanoma.ResultsAfter exclusions, our study group consisted of 82 cases. Immunofluorescence was observed in 40.2% of specimens evaluated for keratin, 50.0% evaluated for osteopontin, 26.8% evaluated for β-catenin, 65.9% evaluated for vimentin, and 70.7% evaluated for LZTS1. Through available follow-up, 27 patients (32.9%) were dead of confirmed or suspected metastatic uveal melanoma. None of the patients whose tumor exhibited strong immunoreactivity to β-catenin died of metastasis. In contrast, patients whose tumor exhibited immunoreactivity of any intensity to LZTS1 were more likely to develop metastasis. In multivariate Cox proportional hazards modeling, a composite variable that took into account the immunostaining for both β-catenin and LZTS1 had a statistically significant relationship with patient’s survival time.ConclusionsOur study suggests that conventional clinical and histopathological prognostic factors, and immunoexpression of β-catenin and LZTS1 combined may allow better prognostication of metastasis than clinical and histomorphological factors alone.