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Expression of p63 is the sole independent marker of aggressiveness in localised (stage I–II) Merkel cell carcinomas
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Expression of p63 is the sole independent marker of aggressiveness in localised (stage I–II) Merkel cell carcinomas
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Journal Article
Expression of p63 is the sole independent marker of aggressiveness in localised (stage I–II) Merkel cell carcinomas
2011
Overview
Merkel cell carcinoma of the skin is a malignant neuroendocrine tumour, whose prognostic criteria are a matter of dispute. Specifically, no predictor is presently available in stage I–II tumours. We collected clinical and follow-up data from 70 Merkel cell carcinomas of the skin. The same cases were studied for p63 expression by immunohistochemistry, by reverse-transcription PCR (RT-PCR) and
TP63
gene status by FISH and for presence of Merkel cell polyomavirus by PCR. Stage emerged as a significant prognostic parameter (
P
=0.008). p63 expression, detected in 61% (43/70) of cases by immunohistochemistry, was associated with both decreased overall survival (
P
<0.0001) and disease-free survival (
P
<0.0001). Variable expression patterns of the different p63 isoforms were found only in cases immunoreactive for p63. In these latter lesions, at least one of the N-terminal p63 isoforms was detected and TAp63
α
was the most frequently expressed isoform.
TP63
gene amplification was observed by FISH in only one case. Presence of Merkel cell polyomavirus DNA sequences was detected in 86% (60/70) of Merkel cell carcinomas and did not emerge as a significant prognostic parameter. Merkel cell carcinoma cases at low stage (stage I-II) represented over half (40/70 cases, 57%) of cases, and the clinical course was uneventful in 25 of 40 cases while 15 cases died of tumour (10/40 cases) within 34 months or were alive with disease (5/40 cases) within 20 months. Interestingly, a very strict correlation was found between evolution and p63 expression (
P
<0.0001). The present data indicate that p63 expression is associated with a worse prognosis in patients with Merkel cell carcinoma, and in localised tumours it represents the single independent predictor of clinical evolution.
Publisher
Nature Publishing Group US,Elsevier Limited
Subject
/ Aged
/ Biomarkers, Tumor - analysis
/ Biomarkers, Tumor - genetics
/ Cancer
/ Carcinoma, Merkel Cell - chemistry
/ Carcinoma, Merkel Cell - genetics
/ Carcinoma, Merkel Cell - mortality
/ Carcinoma, Merkel Cell - pathology
/ Carcinoma, Merkel Cell - therapy
/ Carcinoma, Merkel Cell - virology
/ Cloning
/ Female
/ Humans
/ In Situ Hybridization, Fluorescence
/ Italy
/ Male
/ Medicine
/ Oncology
/ Reverse Transcriptase Polymerase Chain Reaction
/ Transcription Factors - analysis
/ Transcription Factors - genetics
