Cell cycle and apoptosis regulators in Spitz nevi: Comparison with melanomas and common nevi - 12/08/11

Doi : 10.1016/j.jaad.2006.09.015

Christina Stefanaki, MD ^a,^⁎ , Kalliopi Stefanaki, MD ^b, Christina Antoniou, MD ^a, Theodoros Argyrakos, MD ^b, Amalia Patereli, MD ^b, Alexander Stratigos, MD ^a, Andreas Katsambas, MD ^a
^a From the Dermatology Department, Andreas Sygros University Hospital
^b Pathology Department, Agia Sofia Children’s Hospital

Reprint requests: Christina Stefanaki, MD, 10 Karaiskaki St, Ano Ilisia, Athens 15772, Greece.

Athens, Greece

Abstract

Background

Deregulated cell cycle control is one of the hallmarks of tumor development. The expression of different cell cycle regulators has been used in various neoplasms as an adjunct to diagnosis.

Objective

We sough to determine the expression of cell cycle and apoptosis regulators in Spitz nevi and to appraise its value as a diagnostic adjunct in the differential diagnosis from melanomas and common nevi.

Methods

Ki-67, p-27, p-16, p-53, p-21, Rb, cyclin D1, cyclin A, cyclin B1, bcl-2, and bax expression was assessed by immunohistochemistry in 10 Spitz nevi and was compared with 16 melanomas and 20 common nevi immunohistochemical expression.

Results

P-27 (60% ± 20.13), p-16 (62.00% ± 10.85), and bcl-2 (46.00% ± 42.47) were highly expressed in Spitz nevi, whereas Ki-67 (2.80% ± 2.55), Rb (3.75% ± 4.55), p-53 (2.30% ± 0.10), cyclin A (0.70% ± 1.56), B1 (0.20% ± 0.34), and bax (2.65% ± 6.37) demonstrated a limited expression. Cyclin D1 (8.60% ± 7.30) and p-21 (6.40% ± 5.37) showed a moderate expression. The expression of bax (P = .001), Ki-67 (P < .0001), Rb (P < .0001), p-16 (P < .0001), cyclin A (P < .0001), and cyclin B1 (P < .0001) was significantly higher in melanomas in comparison with Spitz nevi, whereas p-27 expression was significantly higher in Spitz nevi (P < .0001). A trend for significant difference in favor of melanomas was also observed for p-53 (P = .002). On the other hand, no difference was detected for bcl-2 (P = .275), p-21 (P = .055), or cyclin D1 (P = .077). Spitz nevi demonstrated a trend for a higher expression for p-21 (P = .008) and cyclin D1 (P = .006), whereas they exhibited lower p-16 (P = .004) in comparison with common nevi.

Limitations

The number of Spitz nevi was relatively small.

Conclusion

Spitz nevi differ from melanomas in their immunohistochemical pattern of expression of cell cycle and apoptosis regulators and more closely resemble common benign nevi.

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