期刊
JOURNAL OF INVESTIGATIVE DERMATOLOGY
卷 128, 期 11, 页码 2696-2704出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/jid.2008.134
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资金
- Radiumhemmet
- Karolinska Institute Research Fund
- Swedish Cancer Society
The aim of this study was to estimate the impact on survival of NRAS and BRAF mutations and activation of Akt and extracellular signal-regulated kinase (ERK) in primary melanomas. A cohort of 57 primary cutaneous T1-2 melanoma tumors was analyzed. Mutation frequency for both genes was 61% (NRAS 26% and BRAF 39%). In a univariate analysis, shorter overall survival was associated with the presence of ulceration (P = 0.001) and BRAF exon 15 mutations (P = 0.005) as well as the absence of nuclear activation of Akt (P = 0.022) and of cytoplasmic activation of ERK (P = 0.003). Unexpectedly, ulceration was a significant adverse prognostic factor only in melanomas with BRAF mutations, whereas there was no effect of ulceration on overall survival in tumors with wild-type BRAF. A multivariate analysis showed that significant independent adverse survival prognostic markers were absence of cytoplasmic activation of ERK (P = 0.007) and ulceration (P = 0.008), whereas BRAF exon 15 mutation status showed a nonsignificant trend (P = 0.066). The absence of cytoplasmic ERK activation in poor prognosis T1-2 melanomas may be associated with activation of some other uncharacterized pathway leading to tumor progression and adverse outcome. Immunohistochemical analysis of cytoplasmic phosphorylated ERK could be used as a prognostic marker in primary melanomas if confirmed in another data set.
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