Diagnostic and Prognostic Value of ProEx C and GLUT1 in Melanocytic Lesions.
BACKGROUND
Melanoma is one of the most aggressive types of skin cancer. The purpose of this study was to evaluate the use of two biomarkers, ProEx C and glucose transporter isoform 1 (GLUT1), in the diagnosis and prognostication of melanoma.


METHODS
We analyzed 129 melanomas and 59 benign nevi in a tissue microarray using immunohistochemical method with antibodies to topoisomerase IIα (TOP2A) and minichromosome maintenance complex component 2 (MCM2) using ProEx C and to GLUT1.


RESULTS
The average proliferative index by ProEx C immunostain was significantly higher in melanomas (37.5%) compared to benign nevi (1.9%) as was the expression of GLUT1 (p<0.0001 respectively). Dermal mitosis was found to correlate positively with both ProEx C and GLUT1 (p=0.003 and p<0.001, respectively). Ulceration and tumor thickness positively correlated with GLUT1 expression (p=0.013 and p=0.033, respectively), but not with ProEx C staining. There was a significant association between increasing ProEx C index and stronger expression of GLUT1 (p<0.001). Kaplan-Meier disease-specific survival analyses indicated that patients whose melanoma exhibited expression of GLUT1 had a significantly lower rate of disease-specific survival than patients whose melanoma did not (p=0.039). However, staining by ProEx C did not show a prognostic significance in disease-specific survival.


CONCLUSIONS
ProEx C and GLUT1 are potentially useful markers in differentiation of melanoma from nevi. Absence of GLUT1 expression in patients with primary melanoma predicts better survival.
Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, U.S.A. Geisel School of Medicine at Dartmouth, Hanover, NH, U.S.A. shaofeng.yan@hitchcock.org.
Shaofeng
S
Yan
Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, U.S.A.
Bryan N
BN
Coffing
Biostatistics Shared Resource, Norris Cotton Cancer Center at Dartmouth, Lebanon, NH, U.S.A.
Zhongze
Z
Li
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, U.S.A.
Haiyi
H
Xie
Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, U.S.A. Geisel School of Medicine at Dartmouth, Hanover, NH, U.S.A.
Jeoffry B
JB
Brennick
Geisel School of Medicine at Dartmouth, Hanover, NH, U.S.A.
Haaris A
HA
Beg
Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, U.S.A.
Heather M
HM
Froehlich
Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, U.S.A. Geisel School of Medicine at Dartmouth, Hanover, NH, U.S.A.
Wendy A
WA
Wells
D000951:Antigens, Neoplasm / Q000378:metabolism*; D004250:DNA Topoisomerases, Type II / Q000378:metabolism*; D004268:DNA-Binding Proteins / Q000378:metabolism*; D051272:Glucose Transporter Type 1 / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D008545:Melanoma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D064111:Minichromosome Maintenance Complex Component 2 / Q000378:metabolism*; D009506:Nevus / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D000075223:Poly-ADP-Ribose Binding Proteins; D011379:Prognosis; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D046888:Tissue Array Analysis
D000951:Antigens, Neoplasm; D004268:DNA-Binding Proteins; D051272:Glucose Transporter Type 1; D000075223:Poly-ADP-Ribose Binding Proteins; C495677:SLC2A1 protein, human; C084859:MCM2 protein, human; D064111:Minichromosome Maintenance Complex Component 2; D004250:DNA Topoisomerases, Type II; C000618811:TOP2A protein, human
GLUT1; ProEx C; benign nevus; cutaneous malignant melanoma; tissue microarray