Increased Nuclear Volume in Metastasizing “Thick” Melanomas

• Published in: Journal of investigative dermatology Vol. 106; no. 3; pp. 437 - 440
• Main Authors: Mossbacher, Ulrike, Knollmayer, Susanne, Binder, Michael, Steiner, Andreas, Wolff, Klaus, Pehamberger, Hubert
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.1996
• Subjects: Adult; Aged; Aged, 80 and over; Cell Nucleus - pathology; Female; Humans; image analysis; Male; Melanoma - pathology; Melanoma - secondary; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Prognosis; prognostic marker; Skin Neoplasms - pathology; image analysis; prognostic marker
• ISSN: 0022-202X; 1523-1747
• DOI: 10.1111/1523-1747.ep12343580

Tumor invasion is the most reliable prognostic factor for primary stage I melanoma. “Thick” melanomas, with a Breslow thickness of more than 4mm, tend to have a poor prognosis. Exceptions occur: some patients have no further recurrence of tumor. In an attempt to determine prognostic markers for “Thick” clinical stage I melanomas, we investigated the volume-weighted mean nuclear volume of primary melanomas with tumor invasions ≥4.0mm in 32 patients. Seventeen of these patients developed melanoma metastases within a follow-up period of 60 mo; 15 patients who did not developed metastases and were comparable with regard to clinical and histological criteria were selected as a comparison group. Volume-weighted mean nuclear volume (Vv is determined by a technique that permits an unbiased, efficient, shape- and orientation-independent, 3-dimensional estimation of nuclear size in tissues. This technique has been employed successfully in the prognostic assessment of stage I and II melanomas and was recently proven to be a sensitive marker for thin, high-risk melanomas. In our patients, Vv, was determined by computer-assisted image analysis on Feulgen-stained sections by stereologic estimation of the Vv. The mean Vv, (± SD) of primary melanomas with subsequent metastatic course was 794.99 ± 209.18 μm3 (range: 409.48-1161.9 μm3), whereas primary melanoma lesions without subsequent metastases exhibited a mean Vv, 640.54 ± 205.07 μm3 (range: 206.7-927.48 μm3). This difference was found to be statistically significant (p = 0.0439). “Thick” melanomas with subsequent metastases thus exhibited a significantly higher Vv, than did melanomas that did not metastasize.