title: Ki-67, p53, and p16 expression, and G691S RET polymorphism in desmoplastic melanoma (DM): A clinicopathologic analysis of predictors of outcome.
abstract: BACKGROUND
  The prognostic role Ki-67, p53, and p16 immunostains and RET (rearranged during transfection) polymorphism in desmoplastic melanoma has not been evaluated.
  
  
  OBJECTIVE
  We sought to identify potential prognostic markers.
  
  
  METHODS
  We performed Ki-67, p53, and p16 immunostains on 66 desmoplastic melanomas, and sequenced RET G691 polymorphism and recurrent mutations of 17 cancer genes in 55 and 20 cases, respectively.
  
  
  RESULTS
  Recurrence and metastasis were documented in 11 of 66 (17%) and 26 of 66 (39%) patients, respectively. Death was noted in 25 of 55 (45%) patients. Ki-67 expression (≥10%, 43%) correlated with male gender (P = .009), ulceration (P = .002), and Breslow depth (P = .009). p53 Expression (≥50%, 28%) correlated with male gender (P = .002) and head and neck location (P = .0228). Using Kaplan-Meier plots, Ki-67 expression (P = .0425) and mitosis (P = .00295) correlated with overall survival, whereas vascular invasion (P = .0292) correlated with disease progression. There was a significant correlation between Ki-67 and p53 expression (P = .003). RET polymorphism was present in 10 of 46 (22%) cases and inversely correlated with Breslow depth (P = .024).
  
  
  CONCLUSIONS
  Our study is small and lacks power to perform a multivariate analysis.
  
  
  CONCLUSIONS
  Although Ki-67 expression correlated with overall survival, additional studies are needed to determine whether Ki-67 would be an independent prognostic marker in addition to the current routine histopathologic assessment.
authors.affiliation: Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Nicholas F
authors.initials: NF
authors.lastname: Lawrence
authors.affiliation: Department of Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Marc R
authors.initials: MR
authors.lastname: Hammond
authors.affiliation: Department of Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Dennie T
authors.initials: DT
authors.lastname: Frederick
authors.affiliation: Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Su
authors.affiliation: Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Dora
authors.initials: D
authors.lastname: Dias-Santagata
authors.affiliation: Department of Pathology, University of Massachusetts Memorial Hospital, Worcester, Massachusetts.
authors.forename: April
authors.initials: A
authors.lastname: Deng
authors.affiliation: Department of Pathology, Duke University Medical Center, Durham, North Carolina.
authors.forename: M Angelica
authors.initials: MA
authors.lastname: Selim
authors.affiliation: Dermatopathology Section, Department of Pathology and Laboratory Medicine, Veterans Affairs Consolidated Laboratories New England, Boston, Massachusetts.
authors.forename: Meera
authors.initials: M
authors.lastname: Mahalingam
authors.affiliation: Department of Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Keith T
authors.initials: KT
authors.lastname: Flaherty
authors.affiliation: Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: mhoang@mgh.harvard.edu.
authors.forename: Mai P
authors.initials: MP
authors.lastname: Hoang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004252:DNA Mutational Analysis; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D019942:Genes, p16; D006801:Humans; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000235:genetics*; D008297:Male; D008545:Melanoma / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D051096:Proto-Oncogene Proteins c-ret / Q000235:genetics; D012878:Skin Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000235:genetics*; D000096142:Cutaneous Malignant Melanoma
chemical_list: D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53; D051096:Proto-Oncogene Proteins c-ret; C099282:RET protein, human
keywords: Ki-67; RET polymorphism; desmoplastic melanoma; immunohistochemistry; p16; p57