nm23 expression in primary cutaneous malignant melanomas

Background and Design: We investigated the correlation between nm23 and tumor depth in primary cutaneous
malignant melanomas (PCMM).
Materials and Methods: Sixteen cases in sun-exposed areas and 10 cases in nonexposed areas were included
into the study. Clark Levels (CL) were determined to evaluate tumor depth. Immunohistochemically
more than 10% of cytoplasmic staining by nm23 was assessed in a semiquantitative fashion. The extent of
staining was estimated as (+), (++), (+++), the intensity of staining was graded as (+), (++), (+++).
Results: There were totally 6 PCMM cases with low Clark level (CL I, II, III). The extent of nm23 staining
was as follows: in 4 cases (+++), in 1 case (++) and in 1 case (+). The intensity of staining was in 5 cases
(+++), in 1 case (++). There were 20 PCMM cases with high CL (CL IV, V). The extent of nm23 staining
was as follows; in 15 cases (+++), in 2 cases (++), there was no staining in 3 cases. The intensity of staining
was (+++) in 6 cases, (+) in 5 cases, (-) in 3 cases. No significant difference regarding the nm 23 positivity
was observed in PCMM in sun exposed areas and nonexposed areas.
Conclusion: In all of the cases with low CL there was nm23 staining. This finding suggests tumor suppressor
potential of nm23. But the number of cases with high CL that weren't stained by nm23 was fewer on
the contrary of the expected. We thougt that nm23 expression may not be related to the depth of tumor invasion.
Besides the fewer expression of the nm23 in PKMM in sun exposed areas may suggest the more
aggressive behaviour in those tumors.

Primer Kutanöz Malin Melanomlarda nm23 Ekspresyonu

Primer kutanöz malin melanomlarda (PKMM) nm23 ekspresyonu ile tümör derinliði arasýnda iliþki olup olmadýðýný araþtýrmak üzere çalýþmaya 16 sý güneþ gören 10 u güneþ görmeyen alanda saptanan 26 PKMM olgusu incelendi. Tümör derinliði Clark Level (CL) ile belirlendi. Ýmmünhistokimyasal olarak nm23 ile tümör hücrelerinde %10 dan fazla sitoplazmik boyanma semikantitatif olarak yaygýnlýk (+,++,+++) ve yoðunluðuna (+,++,+++) göre deðerlendirildi. CL ý düþük olan (CL I, II, III) toplam 6 PKMM olgusunda; nm23 boyanma yaygýnlýðý 4 olguda (+++), 1 olguda (++), 1 olguda (+) idi, boyanma yoðunluðu ise 5 olguda (+++), 1 olguda (++) idi. CL ý yüksek olan (CL IV, V) toplam 20 PKMM olgusu vardý. nm23 boyanma yaygýnlýðý 15 olguda (+++), 2 olguda (++) iken, 3 olguda boyanma gözlenmedi. Boyanma yoðunluðu 6 olguda (+++), 6 olguda (++), 5 olguda (+), 3 olguda (-) idi. Güneþ gören ve görmeyen alanlardaki PKMM larda nm23 pozitivitesinde anlamlý fark saptanmadý. CL ý düþük olgularýn tamamýnda nm23 ile boyanma izlenmesi nm23 ün tümor süpresör etkisini düþündürmektedir ancak CL ý yüksek olgularýn beklenenin aksine, nispeten daha azýnda boyanma olmamasý nm23 ekspresyonunun tümör invazyon derinliðiyle iliþkili olmayabileceðini akla getirmektedir. Ayrýca güneþ gören alanlarda CL ý yüksek PKMM olgularýnda nm23 ekspresyonunun daha az bulunmasý, bu alanlarda görülen PKMM larýn daha agresif olabileceðini düþündürmüþtür.