Molecular prognostic markers in intermediate-thickness cutaneous malignant melanoma

Abstract

BACKGROUND. The limitations of morphologic criteria alone in determining the prognosis for a patient with a particular intermediate-thickness primary melanoma have prompted efforts to identify other markers. METHODS. In this study, the authors analyzed expression of p53, β1 integrin, and β3 integrin in primary tumors from 111 patients with intermediate-thickness malignant melanoma. RESULTS. Eighty-nine (80%) had detectable p53 protein, 58 (52%) expressed β1 integrin, and 71 (64%) expressed β3 integrin. Patients with 3/4 positive melanomas were more likely to die of their disease (32 of 71 patients, 45%) than those with β3 negative tumors (3 of 40 patients, 8%) (P < 0.0001). The number of involved lymph nodes, Clark's level, β1 integrin expression, thickness, and mitotic rate also had prognostic significance. β3 integrin was associated with subsequent lung metastases and β1 integrin with lymph node involvement. CONCLUSIONS. Integrin expression, along with histopathologic criteria, is a prognostic marker for intermediate-thickness malignant melanoma and may indicate the site of subsequent metastasis. These observations may have clinical utility and suggest areas for future investigation.