CELL-PROLIFERATION MARKERS IN PREDICTING METASTASES IN MALIGNANT-MELANOMA

It is often difficult to predict the outcome of melanoma in patients w ith Clark level III-IV disease. We sought to identify markers of cell proliferation which may be useful in predicting prognosis. Patients wi th Clark's level III-TV malignant melanoma who had no local recurrence s or metastases were matched with patients of comparable level and thi ckness who did experience recurrences or metastases. Cell proliferatio n markers p53, proliferating cell nuclear antigen (PCNA), and Ki-67 we re assessed by immunohistochemistry. DNA ploidy was determined by flow cytometry. There was no difference in the expression of p53, PCNA, an d Ki-67 between patients with metastases and patients without metastas es. However, patients with metastases were more likely to have an aneu ploid tumor cell population than were patients without metastases (p < 0.03). Expression of cell proliferation markers do not appear to help predict prognosis in advanced level melanoma; however, aneuploidy may be associated with a greater probability of metastasis.