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AbstractDO.24.04 Evaluation of Ki-67, p16, Estrogen- and Progesteronereceptors regarding the prognosis of conjunctival melanoma Bredow L., Stützel L., Böhringer D., Reinhard T., Auw-Hädrich C.
Universitäts-Augenklinik Freiburg Objective: Melanotic lesions of the skin or conjunctiva can change their appearance or size during pregnancy. Therefore we analysed if the rate of estrogen- (ER) or progesteronereceptors (PR) influences the course of disease in conjunctival melanoma. This was compared to the prognostic value of the proliferation marker Ki-67 and the cell cycle protein p16.
Methods: 28 paraffin-embedded samples of conjunctival melanoma (year 1994-2005) were examined using antibodies against PR, ER (Ab-12), Ki-67 (clone MIB1) and p16. Patient age ranged between 33-90 years, with an average follow-up of 5,2 years (5,4 months - 21 years). 27 conjunctival nevi from patients with similar age distribution served as controls.
Results: 15 melanoma patients (54%) experienced recurrences, and 6 patients (21%) suffered from metastasis of which only one patient survived. The melanoma specimens showed higher expression of Ki-67 compared to nevi (10,7% vs. 1,9%, p<0,001), and a tendency towards higher expression of p16 (40,9% vs. 23%, p=0,12). Within the melanoma group no statistically significant correlation could be found between Ki-67 or p16 and a higher tumour recurrence or mortality rate (p=0,91 and 0,46, resp.). The rate of cells with ER-positive nucleus was similar in the melanoma and nevus group (p=0,36), but we found a tendency towards a higher rate of cells with PR-positive nucleus in the melanoma patients (4,3% vs. 2,3%, p=0,05). A high PR-expression was associated with better survival rate in women (p=0,035).
Conclusions: A high Ki-67-expression or low p16-expression respectively did not prove to be of prognostic relevance in conjunctival melanoma. It could be shown that conjunctival melanomas express hormone receptors, and that a high rate of PR-positive cells in females was associated with a better tumour survival rate. This observation might be the basis for new therapeutical approaches.
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