title: Extent of vascularization as a prognostic indicator in thin (< 0.76 mm) malignant melanomas.
abstract: Angiogenesis in malignant melanoma (MM) was evaluated by comparing mean vessel number (MVN) in Spitz's nevi (SN), thick and thin MMs that metastasized, and thick and thin MMs with > or = 10-year survival. Vessels were identified with antibodies against factor VIII-related antigen (FVIII) and CD34 in 37 MMs (17 < or = 1.9 mm and 20 > or = 4.0 mm) with > or = 10-year follow-up and 10 SN from children (< or = 9 years old). Fields (x250) with the highest vessel density were counted by independent observers blinded to clinical outcome. There were no differences in MVN between SN versus MMs (P = 1.0), but the distribution of vessels was much more uniform in SN. Seven MM pairs (> or = 5.5 mm) and five pairs (< or = 0.75 mm) were matched by sex, age, site, stage, and primary treatment (paired t-test). In the pairs > or = 5.5 mm, there was no correlation with MVN with either metastasis or death (FVIII P = 0.98; CD34 P = 0.85). Among the thin paired lesions, high MVN (FVIII = 46, CD34 = 39) was significantly related not only to metastasis (FVIII P = 0.04, CD34 P = 0.03) but also to death (FVIII P = 0.04, CD34 P = 0.05). MVN does not separate SN versus MM nor predict outcome in thick (> or = 4.0 mm) MMs; however, high MVN (> or = 42 average) is predictive of metastasis and death in MMs < or = 0.75 mm. Larger matched studies are indicated to confirm this observation.
authors.affiliation: Cancer Research Division, Sunnybrook Health Science Centre, Reichmann Research Institute, Toronto, Ontario, Canada.
authors.forename: C H
authors.initials: CH
authors.lastname: Graham
authors.forename: J
authors.initials: J
authors.lastname: Rivers
authors.forename: R S
authors.initials: RS
authors.lastname: Kerbel
authors.forename: K S
authors.initials: KS
authors.lastname: Stankiewicz
authors.forename: W L
authors.initials: WL
authors.lastname: White
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D018952:Antigens, CD34; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D008545:Melanoma / Q000098:blood supply* / Q000401:mortality / Q000556:secondary; D008875:Middle Aged; D018332:Nevus, Epithelioid and Spindle Cell / Q000098:blood supply; D011379:Prognosis; D012878:Skin Neoplasms / Q000098:blood supply* / Q000401:mortality / Q000473:pathology; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D015703:Antigens, CD; D018952:Antigens, CD34; D014841:von Willebrand Factor