İNVAZİV MELANOMLARDA CD271 VE BRAF EKSPRESYONUNUN KLİNİKOPATOLOJİK PARAMETRELERLE VE PROGNOZ İLE İLİŞKİSİNİN İMMÜNOHİSTOKİMYASAL YÖNTEMLE ARAŞTIRILMASI

Amaç Amaç: İnvaziv melanomun (İM) en önemli prognostik faktörleri patolojik evreleme ve metastaz varlığı olarak bilinmektedir. Patolojik evrelemede tümör boyutu, invazyon derinliği, ülserasyon, mitotik indeks önem arz etmektedir. Çalışmamızda BRAF V600E ve CD271’in immünohistokimyasal (İHK) ekspresyonları ile klinikopatolojik parametreler ve prognoz ile ilişkisinin incelenmesi amaçlanmıştır. Gereç ve Yöntem Çalışmamızda Süleyman Demirel Üniversitesi Patoloji Anabilim Dalı’nda Aralık 2010 - Mayıs 2017 tarihleri arasında tanı almış 47 İM olgusu incelendi. Bu olgulara BRAF V600E ve CD271 belirleyicileri uygulandı. Bu belirteçlerin primer ve metastatik İM’lerda ve sağkalım ile ilişkisi immünohistokimyasal yöntemle araştırıldı. Ayrıca primer ve metastatik İM’ların ülser, lenfositik infiltrasyon, pigmentasyon, mitoz, Breslow kalınlığı, metastaz yapıp yapmaması, yaş, cinsiyet ve sağkalım ile ilişkisi araştırıldı. Bulgular Primer İM’ler ve metastatik İM’ler karşılaştırıldığında ülserasyon, mitotik indeks açısından, aralarındaki fark istatistiksel olarak anlamlı bulunurken, Breslow tümör kalınlığı, lenfositik infiltrasyon, pigmentasyon, CD271 ve BRAF V600E ekspresyonu açısından aralarındaki fark istatistiksel olarak anlamlı bulunmadı. Sağkalım ile ilişkilerine bakıldığında Breslow tümör kalınlığı, ülserasyon, BRAF V600E ekspresyonu şiddeti, BRAF V600E ekspresyonu olmayanlar ile olanlar arasındaki ve BRAF V600E ekspresyon şiddeti 3+ olanlar ile diğerleri arasındaki fark istatistiksel olarak anlamlı bulundu. Cinsiyet, pigmentasyon, BRAF V600E ekspresyon yüzdesi, CD271 ekspresyon şiddeti, CD271 ekspresyon yüzdesi ile sağkalım arasında istatistiksel olarak anlamlı fark bulunmadı. Çalışmamızda Primer İM’si olan bireylerin yaşları 35-93 arasında değişmekte olup ortalama 64,12 ± 20,35, metastatik İM grubundaki bireylerin yaşları 35-89 arasında değişmekte olup ortalama 69 ± 13,42 idi. Yaş yönünden iki grup arasındaki fark anlamlı bulunmadı. Sonuç Çalışmamız sonucunda elde ettiğimiz verilerde BRAF V600E ekspresyonu prognoz ile ilişkili olduğu gözükmektedir. BRAF V600E ekspresyonu olmayanlarda yüksek sağkalım oranları varken ekspresyon şiddeti yüksek olanlarda sağkalımın azaldığı bulundu. Çalışmamızda CD271 ekspresyon şiddeti ve yüzdesi açısından primer ve metastatik İM gruplarında ve sağkalım arasında istatistiksel olarak anlamlı fark bulmadık.

Anahtar Kelimeler:

BRAF, CD271, immünohistokimya, prognostik faktörler, İnvaziv melanom

INVESTIGATION OF THE RELATIONSHIP BETWEEN CD271 AND BRAF EXPRESSION WITH CLINICOPATHOLOGICAL PARAMETERS BY IMMUNOHISTOCHEMICAL METHOD IN INVASIVE MELANOMA

Objective Metastasis and pathological staging are considered the primary prognostic indicators for invasive melanoma (IM). Pathological staging is determined by evaluating tumor size, depth of invasion, ulceration, and mitotic index. Our study aims to explore the relationship between the prognosis of BRAF V600E and CD271 and their immunohistochemical expressions, as well as clinicopathological parameters. Materials and Methods Our study analyzed 47 cases of IM that were observed between December 2010 and May 2017 at Süleyman Demirel University's Department of Pathology. These cases were assessed using BRAF V600E and CD271 markers, and their correlation with primary and metastatic IM, as well as survival rates, were examined using immunohistochemical analysis. We also investigated the relationship between referral, lymphocytic infiltration, pigmentation, mitosis, Breslow depth, lack of metastasis screening, age, gender, and survival to provide a comprehensive understanding of the factors that may influence the disease progression and patient outcomes. Results The age of the primary IM patients ranged from 35 to 93 years old, with an average of 64.12 ± 20.35 years. The age of the metastatic IM patients ranged from 35 to 89 years old, with an average of 69 ± 13.42 years. Our analysis did not reveal any statistically significant differences in age between these two groups. Significant statistical differences were observed between primary IM and metastatic IM in terms of ulceration and mitotic index. However, there were no significant differences between these two groups in Breslow tumor thickness, lymphocytic infiltration, pigmentation, or the expression of CD271 and V600E. In terms of survival, statistically significant differences were observed in relation to Breslow tumor thickness, ulceration, and the intensity of BRAF V600E expression, as well as between individuals with and without expression of BRAF V600E, specifically in cases with a 3+ expression intensity. No significant differences were observed in relation to gender, pigmentation, BRAF V600E percentage of expression, CD271 expression intensity, or survival. We did not determine a statistically significant difference between primary and metastatic IM groups and survival in terms of CD271 expression severity and percentage in our study. Conclusion In summary, our findings suggest that the expression of BRAF V600E is associated with prognosis, with patients without this expression exhibiting a higher survival rate. However, our results indicate that the survival rate decreases as the intensity of expression increases.

Keywords:

BRAF, CD271, immunohistochemistry, prognostic factors, invasive melanoma,

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