Study of Microsatellite Instability by Immunohistochemistry in a Cohort of Patients With Melanoma.

IF 1.6 4区医学 Q3 DERMATOLOGY Journal of Cutaneous Pathology Pub Date : 2024-11-24 DOI:10.1111/cup.14758

Rodolfo David Palacios Diaz, Blanca de Unamuno Bustos, Mónica Pozuelo Ruiz, Margarita Llavador Ros, Sarai Palanca Suela, Rafael Botella Estrada

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Abstract

Background: Microsatellite instability (MSI) has prognostic value and impacts therapy strategies in several malignancies. Data regarding MSI in melanoma are scarce. The aim of this study was to assess MSI through the analysis of MMR protein expression in patients with melanoma.

Methods: An observational retrospective single-center study was designed based on patients with primary melanoma. We assessed MSI through immunohistochemical staining with anti-MLH1, anti-MSH2, anti-MSH6, and anti-PMS2 on full-thickness excision tissue.

Results: Ninety-three patients were included in this study. The complete absence of nuclear staining in tumoral cells was extremely rare, with only one melanoma not expressing MSH6. Most melanomas showed an expression index for MLH1 (77.7%), MSH2 (87.2%), and PMS2 (78.6%) ≥ 75%. Most melanomas (57.8%) exhibited an MSH6 expression index in the range of 1%-74%. A low MSH6 expression index and a reduced combined MMR protein expression index (MMR-e) were significantly associated with higher melanoma-specific survival. A mild PMS2 staining intensity was significantly associated with a higher melanoma-specific survival. The patients with high MMR-e who received immunotherapy progressed and died more frequently than those with reduced MMR-e (75% vs. 33.3%).

Conclusion: More studies are needed to further define the role of MSI in melanoma prognosis and response to immunotherapy.

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用免疫组化方法研究黑色素瘤患者队列中的微卫星不稳定性

背景：微卫星不稳定性（MSI）具有预后价值，并对多种恶性肿瘤的治疗策略产生影响。有关黑色素瘤中微卫星不稳定性的数据很少。本研究旨在通过分析黑色素瘤患者的 MMR 蛋白表达来评估 MSI：方法：我们设计了一项基于原发性黑色素瘤患者的观察性回顾性单中心研究。我们通过对全厚切除组织进行抗MLH1、抗MSH2、抗MSH6和抗PMS2免疫组化染色来评估MSI：本研究共纳入 93 例患者。肿瘤细胞中完全没有核染色的情况极为罕见，只有一个黑色素瘤没有表达 MSH6。大多数黑色素瘤的 MLH1（77.7%）、MSH2（87.2%）和 PMS2（78.6%）表达指数≥75%。大多数黑色素瘤（57.8%）的MSH6表达指数在1%-74%之间。较低的MSH6表达指数和较低的MMR蛋白综合表达指数（MMR-e）与较高的黑色素瘤特异性生存率显著相关。轻度PMS2染色强度与较高的黑色素瘤特异性存活率明显相关。接受免疫治疗的高MMR-e患者比MMR-e较低的患者更容易恶化和死亡（75%对33.3%）：结论：需要更多的研究来进一步明确MSI在黑色素瘤预后和免疫治疗反应中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cutaneous Pathology 医学-病理学

CiteScore

3.20

自引率

5.90%

发文量

174

审稿时长

3-8 weeks

期刊介绍： Journal of Cutaneous Pathology publishes manuscripts broadly relevant to diseases of the skin and mucosae, with the aims of advancing scientific knowledge regarding dermatopathology and enhancing the communication between clinical practitioners and research scientists. Original scientific manuscripts on diagnostic and experimental cutaneous pathology are especially desirable. Timely, pertinent review articles also will be given high priority. Manuscripts based on light, fluorescence, and electron microscopy, histochemistry, immunology, molecular biology, and genetics, as well as allied sciences, are all welcome, provided their principal focus is on cutaneous pathology. Publication time will be kept as short as possible, ensuring that articles will be quickly available to all interested in this speciality.