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Reduced H3K27me3 Expression Is Common in Nodular Melanomas of Childhood Associated With Congenital Melanocytic Nevi But Not in Proliferative Nodules.

H3K27me3表达减少在先天性色素痣相关的儿童结节性恶性黑色素瘤中常见、在增生性结节中不常见

Busam KJ,Shah KN,Gerami P,Sitzman T,Jungbluth AA,Kinsler V

Abstract

The formation of a nodule within a congenital melanocytic nevus (CMN) raises concerns about possible melanoma. Most new nodular growths that develop during childhood, however, are benign proliferative nodules (PN); melanoma is very rare. The distinction of melanoma from PN can at times be difficult clinically and histopathologically, requiring ancillary molecular tests for diagnosis. Although the application of molecular methods has revealed new insights into the mutational and genomic landscape of childhood melanomas, little is known about epigenetic events that may drive the growth of a melanoma or PN in a CMN. In this study we compared the expression of H3K27me3, a key regulator in chromatin remodelling-controlled transcription, in PNs and pediatric nodular melanomas arising within medium-sized to large CMN by immunohistochemistry. Significant loss of H3K27me3 expression was seen in 4 of 5 melanomas, but not in any of the 20 PNs. This observation suggests that epigenetic events likely play a role in the pathogenesis of melanoma developing in the dermis or subcutis of CMN. Furthermore, assessing for H3K27me3 expression by immunohistochemistry may be diagnostically useful for problematic cases.

摘要

先天性色素痣(CMN)中形成结节会让人们担心可能会恶化成恶性黑色素瘤。大多数童年时期形成的结节都是良性的增生性结节(PN),恶性黑色素瘤很罕见。无论是在临床上还是在组织病理学上,恶性黑色素瘤和PN的鉴别有时候都很困难,需要分子检测辅助诊断。利用分子手段,我们对儿童恶性黑色素瘤的突变和基因有了全新的认识,尽管如此,对于促使CMN转变为恶性黑色素瘤或PN的表观遗传异常,我们仍然知之甚少。本研究中,利用免疫组织化学染色,我们比较了产生于中等大小以上CMN的PNs和儿童结节性恶性黑色素瘤中H3K27me3(核染色质中的一种关键的调控基因)的表达。5例恶性黑色素瘤中,4例明显表达缺失;而20例PNs全部阳性表达。该观察结果提示,在CMN真皮或皮下组织恶性黑色素瘤的形成过程中,表观遗传异常可能在其病理机制中起到重要作用。此外,通过免疫组化评价H3K27me3的表达在疑难病例的诊断中或许会有帮助。

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