Expression of estrogen receptors in spitz and reed nevi.

Abstract

BACKGROUND Estrogens play a key role in the skin: they are associated with an increased production of melanin, proliferation of melanocytes, increased skin thickness and increased cutaneous vascularization. Spitz and Reed nevi are acquired melanocytic lesions that generally develop during childhood or adolescence, a period of changes in sex hormones background. Our study project aimed at investigating, through immunohistochemical analysis, the expression levels of ERß receptors and their expression patterns (cytoplasmic or nuclear) in Spitz and Reed nevi. METHODS In our study we collected a total of 86 melanocytic lesions of patients: of these, 16 were common nevi, 23 were Spitz nevi, 18 were Reed nevi and 29 were melanomas. Expression curves for estrogen receptors were constructed using the Kaplan-Meier method and compared using a log-rank test.Statistical analysis was performed using MedCalc®. Immunohistochemical analysis on all histological sections of nevi and melanomas was performed to evaluate the expression levels of of ERß and their expression patterns (cytoplasmic or nuclear). The agreement between the operators was calculated using Fleiss κ values. RESULTS Correlation between immunoreactivity for the β-estrogen receptor and the sex of patients with Spitz and Reed nevi: immunoreactivity was higher in male patients. Correlation between β-estrogen receptor immunoreactivity and patient age for Spitz and Reed nevi: No statistically significant correlation was observed. Correlation between immunoreactivity for the β-estrogen receptor and histotype: Spitz and Reed nevi showed a high intensity, while in common nevi and in melanomas the immunoreactive was low. Correlation between receptor immunoreactivity for β estrogens and Breslow thickness in melanomas: Breslow thickness of non-immunoreactive melanomas for ERβ was much higher than those showing high immunoreactivity for this reeptor. CONCLUSIONS Spitz and Reed nevi express a higher immunoreactivity for estrogens than common nevi and melanomas, especially those with a high Breslow thickness; and immunoreactivity is higher in younger age groups.