title: Nestin expression is associated with aggressive cutaneous melanoma of the nodular type.
abstract: The intermediate filament nestin, a neural stem-cell marker, is reported to be expressed more strongly in melanomas compared with benign melanocytic lesions, and increasingly expressed in advanced melanoma stages. However, the prognostic impact of nestin on melanoma has not been well elucidated. The aim of the present study was to evaluate the prognostic influence of nestin expression in cutaneous melanoma in comparison with standard clinico-pathologic variables. In a large series of nodular cutaneous melanoma (n=348), nestin expression was assessed by immunohistochemistry using tissue microarray (TMA) sections. For comparison, nestin staining in corresponding metastases as well as in superficial spreading melanomas and benign nevi was also examined. Nestin was expressed to varying degrees in a majority of nodular melanomas (92%), and was significantly associated with increased tumor thickness, high mitotic count, and the presence of ulceration and tumor necrosis. Also, expression was stronger in the nodular type than in superficial spreading melanomas and benign nevi, but without significant difference when compared with matched metastases from the former. Importantly, strong expression of nestin was significantly associated with reduced survival in multivariate analysis. In conclusion, increased nestin expression was associated with aggressive melanoma features, with independent prognostic impact on multivariate survival analysis when compared with clinico-pathologic factors.
authors.affiliation: Section for Pathology, The Gade Institute, University of Bergen, Bergen, Norway.
authors.forename: Rita G
authors.initials: RG
authors.lastname: Ladstein
authors.affiliation: 1] Section for Pathology, The Gade Institute, University of Bergen, Bergen, Norway [2] Department of Dermatology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Ingeborg M
authors.initials: IM
authors.lastname: Bachmann
authors.affiliation: 1] Section for Pathology, The Gade Institute, University of Bergen, Bergen, Norway [2] Department of Oncology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Oddbjørn
authors.initials: O
authors.lastname: Straume
authors.affiliation: 1] Section for Pathology, The Gade Institute, University of Bergen, Bergen, Norway [2] Department of Pathology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Lars A
authors.initials: LA
authors.lastname: Akslen
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D064231:Nestin / Q000096:biosynthesis*; D011379:Prognosis; D012878:Skin Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; C577484:NES protein, human; D064231:Nestin