恶性黑素瘤细胞周期素D3及增殖细胞核抗原的表达

Expression of Cyclin D3 and PCNA in Cutaneous Malignant Melanoma

目的探讨恶性黑素瘤中细胞周期素D3和增殖细胞核抗原(PCNA)的表达及临床意义。方法采用免疫组化SP法检测57例原发性皮肤恶性黑素瘤及37例转移性恶性黑素瘤中细胞周期素D3和PCNA的表达,并以20例良性痣作为对照。结果①原发性皮肤恶性黑素瘤及转移性恶性黑素瘤中细胞周期素D3的阳性表达及PCNA的表达较良性痣均有不同程度增强;转移性恶性黑素瘤中两者的表达较原发性皮肤恶性黑素瘤也有不同程度增强。②两者在原发性皮肤恶性黑素瘤中的表达与病理Clark分级及淋巴结转移状态显著相关。③浅表扩散性恶性黑素瘤中细胞周期素D3阴性组的3年存活率显著高于细胞周期素D3阳性组,浅表扩散性恶性黑素瘤及结节性恶性黑素瘤中PCNA低表达组3年存活率明显高于PCNA高表达组。④浅表扩散性恶性黑素瘤及转移性恶性黑素瘤中细胞周期素D3阳性表达与PCNA高表达呈正相关。结论细胞周期素D3及PCNA的表达可能与原发性皮肤恶性黑素瘤的发生发展有关,对于治疗方案的选择及预后评估都具有重要的临床意义,细胞周期素D3的表达水平可作为浅表扩散性恶性黑素瘤临床预后的预测因子。

Objective To investigate the expression of cyclin D3 and proliferating cell nuclear antigen (PCNA) and their clinical significance in mal ignant melanoma. Methods The expression of cyclin D3 and PCNA was measured by streptavidin-peroxidase complex immunohistochemical technique in 57 cases of pri mary cutaneous malignant melanoma (CMM), 37 cases of metastatic melanoma and 20 cases of benign nevi. Results The positive expression rate of cyclin D3 in CM M and metastatic melanoma were 35.1% and 59.5% respectively, while the high expr ession rate of PCNA were 57.9% and 78.6% respectively. Compared with that in ben ign nevi, the expression of cyclin D3 and PCNA was significantly increased. The expression of cyclin D3 and PCNA in CMM was positively related to Clark′s grade and the metastasis to lymph nodes. The 3-year survival rate in patients with ne gative expression of cyclin D3 was significantly higher than that with positive expression in superficial melanomas. The 3-year survival rate of patients with l ow expression of PCNA was significantly higher than that with high expression in CMM. The expression of cyclin D3 was positively correlated with the high expres sion of PCNA in superficial and metastatic melanomas. Conclusions The expressi on of cyclin D3 and PCNA may be involved in the carcinogenesis process and progr ession of CMM and have important implications in the selection of therapeutic re gimens and prognostic assessment. The expression level of cyclin D3 may be regar ded as a prognostic factor for superficial melanoma.