Clin Exp Otorhinolaryngol.  2008 Dec;1(4):206-210.

Ki67 Antigen as a Predictive Factor for Prognosis of Sinonasal Mucosal Melanoma

Affiliations
  • 1Department of Otorhinolaryngology, College of Medical and Research Center for Sensory Organs, Medical Research Center, Seoul National University, Seoul, Korea. csrhee@snu.ac.kr
  • 2Allergy & Clinical Immunology, Medical Research Center, Seoul National University, Seoul, Korea.

Abstract


OBJECTIVES
Sinonasal mucosal melanoma is a rare and aggressive disease. The aim of this study was to analyze the clinical features of patients with sinonasal mucosal melanoma and to determine the role of Ki67 antigen as a predictor of prognosis in sinonasal mucosal melanoma. METHODS: This was a retrospective case- series study at a single institution, an academic tertiary referral center. From 1995 to 2007, 27 patients with sinonasal mucosal melanoma were reviewed retrospectively, and the expression of Ki67 antigen was assessed by immunohistochemistry. RESULTS: The overall 5-yr survival rate was 33.9%. No significant differences were observed in 5-yr survival according to age, sex, stage, or the presence of melanin. The rates of local failure, regional failure, and distant failure were 37.0%, 14.8%, and 11.1%, respectively. Patients with spindle or mixed cell types had better prognoses than those with other cell types. At a cut-off value of 35%, patients with lower Ki67 scores showed better survival than those with higher Ki67 scores. CONCLUSION: The presence of spindle or mixed cell types may indicate a better prognosis than other cell types. Ki67 immunostaining may be a useful predictor of prognosis in patients with mucosal malignant melanoma of the sinonasal tract.

Keyword

Ki67 antigen; Melanoma; Nasal cavity; Paranasal sinuses

MeSH Terms

Humans
Immunohistochemistry
Melanins
Melanoma
Nasal Cavity
Paranasal Sinuses
Prognosis
Retrospective Studies
Survival Rate
Tertiary Care Centers
Melanins

Figure

  • Fig. 1 (A) Ki67 staining was detected in 80% of tumor cell nuclei under a light microscope (original magnification ×400). (B) Ki67 staining was detected in 10% of tumor cell nuclei under a light microscope (original magnification ×400).

  • Fig. 2 The 5-yr survival rate for patients with mucosal malignant melanoma of the sinonasal tract is 35.3%.

  • Fig. 3 (A) We determined cut-off value at 35% by ROC curve. (B) Patients with scores of <35% for Ki67 staining have a distinct survival advantage over those patients with scores of ≥35%.


Reference

1. Holdcraft J, Gallagher JC. Malignant melanomas of the nasal and paranasal sinus mucosa. Ann Otol Rhinol Laryngol. 1969; 2. 78(1):5–20. PMID: 5763191.
2. Thompson LD, Wieneke JA, Miettinen M. Sinonasal tract and nasopharyngeal melanomas: a clinicopathologic study of 115 cases with a proposed staging system. Am J Surg Pathol. 2003; 5. 27(5):594–611. PMID: 12717245.
Article
3. Freedman HM, DeSanto LW, Devine KD, Weiland LH. Malignant melanoma of the nasal cavity and paranasal sinuses. Arch Otolaryngol. 1973; 4. 97(4):322–325. PMID: 4699540.
Article
4. Berthelsen A, Andersen AP, Jensen TS, Hansen HS. Melanomas of the mucosa in the oral cavity and the upper respiratory passages. Cancer. 1984; 9. 01. 54(5):907–912. PMID: 6744219.
Article
5. Hong SL, Kim SW, Won TB, Shim WS, Kim YM, Kim JW, et al. Clinical features and treatment outcomes of mucosal malignant melanomas of nasal cavity and paranasal sinuses. Korean J Otolaryngol-Head Neck Surg. 2006; 12. 49(12):1176–1180.
6. Patel SG, Prasad ML, Escrig M, Singh B, Shaha AR, Kraus DH, et al. Primary mucosal malignant melanoma of the head and neck. Head Neck. 2002; 3. 24(3):247–257. PMID: 11891956.
Article
7. Shah JP, Huvos AG, Strong EW. Mucosal melanomas of the head and neck. Am J Surg. 1977; 10. 134(4):531–535. PMID: 911040.
Article
8. Linden MD, Torres FX, Kubus J, Zarbo RJ. Clinical application of morphologic and immunocytochemical assessments of cell proliferation. Am J Clin Pathol. 1992; 5. 97(5 Suppl 1):S4–S13. PMID: 1575220.
9. Cuevas E, Jones DB, Wright DH. Immunohistochemical detection of tumour growth fraction (Ki-67 antigen) in formalin-fixed and routinely processed tissues. J Pathol. 1993; 4. 169(4):477–478. PMID: 8501545.
Article
10. Stern SJ, Guillamondegui OM. Mucosal melanoma of the head and neck. Head Neck. 1991; Jan–Feb. 13(1):22–27. PMID: 1989926.
Article
11. Takagi M, Ishikawa G, Mori W. Primary malignant melanoma of the oral cavity in Japan. With special reference to mucosal melanosis. Cancer. 1974; 8. 34(2):358–370. PMID: 4853771.
Article
12. Kingdom TT, Kaplan MJ. Mucosal melanoma of the nasal cavity and paranasal sinuses. Head Neck. 1995; May–Jun. 17(3):184–189. PMID: 7782202.
Article
13. Chiu NT, Weinstock MA. Melanoma of oronasal mucosa. Population-based analysis of occurrence and mortality. Arch Otolaryngol Head Neck Surg. 1996; 9. 122(9):985–988. PMID: 8797564.
Article
14. Manolidis S, Donald PJ. Malignant mucosal melanoma of the head and neck: review of the literature and report of 14 patients. Cancer. 1997; 10. 15. 80(8):1373–1386. PMID: 9338460.
15. Batsakis JG, Regezi JA, Solomon AR, Rice DH. The pathology of head and neck tumors: mucosal melanomas, part 13. Head Neck Surg. 1982; May–Jun. 4(5):404–418. PMID: 7096100.
Article
16. Prasad ML, Patel SG, Huvos AG, Shah JP, Busam KJ. Primary mucosal melanoma of the head and neck: a proposal for microstaging localized, Stage I (lymph node-negative) tumors. Cancer. 2004; 4. 15. 100(8):1657–1664. PMID: 15073854.
17. Rinaldo A, Shaha AR, Patel SG, Ferlito A. Primary mucosal melanoma of the nasal cavity and paranasal sinuses. Acta Otolaryngol. 2001; 12. 121(8):979–982. PMID: 11813907.
Article
18. Ben-Izhak O, Bar-Chana M, Sussman L, Dobiner V, Sandbank J, Cagnano M, et al. Ki67 antigen and PCNA proliferation markers predict survival in anorectal malignant melanoma. Histopathology. 2002; 12. 41(6):519–525. PMID: 12460204.
Article
19. Niezabitowski A, Czajecki K, Ryś J, Kruczak A, Gruchala A, Wasilewska A, et al. Prognostic evaluation of cutaneous malignant melanoma: a clinicopathologic and immunohistochemical study. J Surg Oncol. 1999; 3. 70(3):150–160. PMID: 10102344.
Article
Full Text Links
  • CEO
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr