title: Evaluation of the proliferation marker MIB-1 in the prognosis of cutaneous malignant melanoma.
abstract: BACKGROUND
  The proliferation marker MIB-1, which recognizes the Ki-67 antigen, provides independent prognostic information in several tumor types. Its utility in melanoma has been evaluated mostly in studies of thick primary tumors. Its usefulness in thinner lesions has not been assessed adequately.
  
  
  METHODS
  A well characterized cohort of 137 patients diagnosed with primary cutaneous melanoma at the New York University School of Medicine between 1972 and 1982 was studied based on the availability of representative tissues and adequate clinical follow-up. Twenty-one tumors were less than or equal to 1.0 mm thick, 94 were between 1.01 and 4.0 mm thick, and 22 were thicker than 4.0 mm. Tumor cell proliferation was assessed by immunohistochemistry using the monoclonal antibody MIB-1. MIB-1 expression was correlated with baseline clinicopathologic parameters, as well as recurrence (RR), disease-free (DFS), and overall survival (OS) rates. Median follow-up among survivors was 6.5 years (range, 5.6-17.5).
  
  
  RESULTS
  High proliferative index, defined as 20% or more of tumor cells showing nuclear immunoreactivity, was observed in 65 of 137 (47.4%) cases. High proliferative index was significantly correlated with increased tumor thickness (P < 0.001) and higher stage (P = 0.03). Trends approaching statistical significance were observed with ulceration of the primary tumor (P = 0.09), male gender (P = 0.06), and shorter DFS (P = 0.12). No significant associations were seen between high proliferative index and RR or OS. In multivariate analyses, tumor thickness was the strongest predictor of clinical outcome.
  
  
  CONCLUSIONS
  In primary cutaneous melanoma, a high proliferative index is associated with clinicopathologic parameters predictive of worse clinical outcomes. However, it was not an independent predictor of clinical outcome.
authors.affiliation: Ronald O. Perelman Department of Dermatology, New York University School of Medicine/Veterans Affairs Medical Center, 550 First Avenue, New York, NY 10010, USA.
authors.forename: Carole
authors.initials: C
authors.lastname: Hazan
authors.forename: Kate
authors.initials: K
authors.lastname: Melzer
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Panageas
authors.forename: Eric
authors.initials: E
authors.lastname: Li
authors.forename: Hideko
authors.initials: H
authors.lastname: Kamino
authors.forename: Alfred
authors.initials: A
authors.lastname: Kopf
authors.forename: Carlos
authors.initials: C
authors.lastname: Cordon-Cardo
authors.forename: Iman
authors.initials: I
authors.lastname: Osman
authors.forename: David
authors.initials: D
authors.lastname: Polsky
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D008545:Melanoma / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012878:Skin Neoplasms / Q000378:metabolism / Q000473:pathology*; D016019:Survival Analysis
chemical_list: D019394:Ki-67 Antigen