Extent of vascularization as a prognostic indicator in thin (< 0.76 mm) malignant melanomas

Am J Pathol. 1994 Sep;145(3):510-4.

Abstract

Angiogenesis in malignant melanoma (MM) was evaluated by comparing mean vessel number (MVN) in Spitz's nevi (SN), thick and thin MMs that metastasized, and thick and thin MMs with > or = 10-year survival. Vessels were identified with antibodies against factor VIII-related antigen (FVIII) and CD34 in 37 MMs (17 < or = 1.9 mm and 20 > or = 4.0 mm) with > or = 10-year follow-up and 10 SN from children (< or = 9 years old). Fields (x250) with the highest vessel density were counted by independent observers blinded to clinical outcome. There were no differences in MVN between SN versus MMs (P = 1.0), but the distribution of vessels was much more uniform in SN. Seven MM pairs (> or = 5.5 mm) and five pairs (< or = 0.75 mm) were matched by sex, age, site, stage, and primary treatment (paired t-test). In the pairs > or = 5.5 mm, there was no correlation with MVN with either metastasis or death (FVIII P = 0.98; CD34 P = 0.85). Among the thin paired lesions, high MVN (FVIII = 46, CD34 = 39) was significantly related not only to metastasis (FVIII P = 0.04, CD34 P = 0.03) but also to death (FVIII P = 0.04, CD34 P = 0.05). MVN does not separate SN versus MM nor predict outcome in thick (> or = 4.0 mm) MMs; however, high MVN (> or = 42 average) is predictive of metastasis and death in MMs < or = 0.75 mm. Larger matched studies are indicated to confirm this observation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Antigens, CD / analysis
  • Antigens, CD34
  • Child
  • Follow-Up Studies
  • Humans
  • Melanoma / blood supply*
  • Melanoma / mortality
  • Melanoma / secondary
  • Middle Aged
  • Nevus, Epithelioid and Spindle Cell / blood supply
  • Prognosis
  • Skin Neoplasms / blood supply*
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology
  • von Willebrand Factor / analysis

Substances

  • Antigens, CD
  • Antigens, CD34
  • von Willebrand Factor