Association of vascular endothelial growth factor expression with patohistological parameters of cutaneous melanoma

Gačevič, Milomir; Jović, Milena; Zolotarevski, Lidija; Stanojević, Ivan; Novaković, Marijan; Miller, Karolina; Šuljagić, Vesna; Mijušković, Željko; Vojvodić, Danilo

doi:10.2298/vsp140804027G

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Vojnosanitetski pregled

2016, vol. 73, br. 5, str. 449-457

Udruženost ekspresije vaskularnog endotelnog faktora rasta sa patohistološkim parametrima kožnih melanoma

Gačevič Milomir^a, Jović Milena^b, Zolotarevski Lidija^c, Stanojević Ivan^d, Novaković Marijan^a, Miller Karolina^e, Šuljagić Vesna^f

, Mijušković Željko^g

, Vojvodić Danilo^d

^aVojnomedicinska akademija, Klinika za plastičnu hirurgiju i opekotine, Beograd + Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd
^bVojnomedicinska akademija, Institut za patologiju i sudsku medicinu, Beograd
^cUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd + Vojnomedicinska akademija, Institut za patologiju i sudsku medicinu, Beograd
^dUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd + Vojnomedicinska akademija, Institut za medicinska istraživanja, Beograd
^eDorset County Hospital Foundation Trust, Dorchester, UK
^fUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd + Vojnomedicinska akademija, Odsek za prevenciju i kontrolu bolničkih infekcija, Beograd
^gUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd + Vojnomedicinska akademija, Klinika za kožne i polne bolesti, Beograd

e-adresa: milomir.gacevic@gmail.com

Ključne reči: melanom; koža; vaskularni endotelni faktori rasta; histologija; immunohistohemija; osetljivost i specifičnost

Sažetak

Uvod/Cilj. Melanom je najagresivniji maligni tumor kože. Do sada su objavljeni kontradiktorni podaci o vaskularnom endotelnom faktoru rasta (VGEF) prisutnom u uzorcima tumora, kao i njegovoj ulozi u progresiji i prognozi melanoma kože. Cilj ove studije bio je da se ispita značaj ekspresije VEGF kao prognostičkog parametra kod melanoma. Metode. Eksperimentalna grupa sastojala se od 81 bolesnika sa primarnim melanomom kože lečenih na Vojnomedicinskoj akademiji, Beograd, od 2009. do 2013. godine. Kontrolna grupa sastojala se od 20 bolesnika sa displastičnim i 20 sa benignim nevusima. Stratifikacija je izvršena prema polu, starosti, kliničkom i histološkom stadijumu, lokalizaciji, histološkom tipu, Clark-u, Breslovu, broju mitoza, regresiji i ulceraciji, prisustvu tumorinfiltrišucih limfocita i načinu širenja. Imunohistohemijsko bojenje izvedeno je na biopsijama kože uz upotrebu DAKO anti-VEGF antitela, LSABTM + HRP, Liquid DAB i mikrotalasnog demaskiranja u DAKO pH 9.0 rastvoru. Za statističku obradu korišćenisu testovi ANOVA, Bonferroni post-test, Mann-Whitney i Wilcoxon test. Rezultati. Prosečan intenzitet VEGF bojenja bio je značajno veći u melanomima nego u benignim ili displastičnin nevusima, a u melanomima bio je najveći u Ia i IV kliničkom stadijumu. Većina melanoma u pT1a patološkom stadijumu imala je najveće prosečne vrednosti VEGF. Melanomi sa najvećim brojem mitoza (> 6) imali su značajno veći intenzitet VEGF bojenja nego oni sa < 2 mitoze. Melanomi bez limfocitne infiltracije imali su najveće vrednosti VEGF, dok su oni sa najintenzivnijom infiltracijom imali najniže vrednosti. Ova razlika je bila statistički visokoznačajna. Melanomi sa limfnim i hematogenim načinom širenja imali su najveće prosečne vrednosti VEGF. Nije bilo statistički značajne korelacije između intenziteta VEGF bojenja i bilo kog drugog parametra. Zaključak. U primarnim melanomima kože povećana ekspresija VEGF značajna je za tumorsku progresiju, a povezana je kako sa odsustvom limfocitne infiltracije, tako i sa prisustvom limfovaskularne invazije. Potrebna su detaljnija prospektivna istraživanja ekspresije VEGF kao prognostičkog parametra kod melanoma na većem broju bolesnika.

Abstract

Background/Aim. Melanoma is the most aggressive malignant tumor of the skin. Contradictory data was published on vascular endothelial growth factor (VGEF) in tumor samples and its role in skin melanoma progression and prognosis. The aim of this study was to investigate the significance of VEGF expression as a prognostic parameter in melanoma. Methods. The experimental group included 81 patients with primary skin melanomas treated from 2009 to 2013 at the Military Medical Academy, Belgrade. The control group included 20 patients with dysplastic and 20 with benign naevi. Stratification was done according to gender, age, clinical and patological stage, localization, histologic type, Clark's, Breslow, mitotic count, regression and ulceration, tumor infiltrating lymphocytes and metastatic spread. Immunohistochemical staining was performed on skin biopsies using DAKO anti-VEGF antibodies (Ab), LSABTM +HRP, DAB and microvawe antigen (Ag) retrieval in DAKO pH 9.0 solution. For statistical data analysis was done with ANOVA, Bonferroni, Mann Whitney and Wilcoxon test. Results. The mean intensity of VEGF staining was statistically significantly higher in melanomas than in benign or dysplastic naevi. Furthermore, the highest recorded values were in Ia and IV clinical stages. The majority of melanomas with high intensity of VEGF staining were in pT1a pathological stage. Melanomas with the highest mitotic count (> 6) had a significantly higher intensity of VEGF staining than those with < 2 mitoses. The highest intensity of staining was in melanomas without significant lymphocytic infiltrate and the lowest was in those with brisk lymphocytic infiltrate, thus a statistical difference was significant. The mean intensity of VEGF staining was highest in melanomas with lymphovascular invasion. There was no statistically significant difference between VEGF and any other parameter. Conclusion. VEGF in primary skin melanomas plays an important role in tumor progression and is linked to the absence if tumor infiltrating lymphocytes and the presence of lymphovascular invasion. More detailed studies have to be done on VEGF prognostic value in melanoma on a larger number of patients.

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O članku

jezik rada: engleski
vrsta rada: izvorni naučni članak
DOI: 10.2298/vsp140804027G
objavljen u SCIndeksu: 06.05.2016.
metod recenzije: dvostruko anoniman

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