Issue: Vojnosanit Pregl 2016; Vol. 73 (No. 5)

Association of vascular endothelial growth factor expression with patohistological parameters of cutaneous melanoma

Authors:
Milomir Gačević†, Milena Jović‡, Lidija Zolotarevski†‡, Ivan Stanojevi憧, Marijan Novaković†, Karolina Miller║, Vesna Šuljagi憶, Željko Mijušković†, Danilo Vojvodi憧

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Background/Aim. Melanoma is the most aggresive malig-nant tumor of the skin. Contradictory data was published on vascular endothelial growth factor (VGEF) in tumor samples and its role in skin melanoma progression and prognosis. The aim of this study was to investigate the sig-nificance of VEGF expression as a prognostic parameter in melanoma. Methods. The experimental group included 81 patients with primary skin melanomas treated from 2009 to 2013 at the Military Medical Academy, Belgrade. The con-trol group included 20 patients with dysplastic and 20 with benign naevi. Stratification was done according to gender, age, clinical and patological stage, localization, histologic type, Clark’s, Breslow, mitotic count, regression and ulcera-tion, tumor infiltrating lymphocytes and metastatic spread. Immunohistochemical staining was performed on skin bi-opsies using DAKO anti-VEGF antibodies (Ab), LSABTM +HRP, DAB and microvawe antigen (Ag) retrieval in DAKO pH 9.0 solution. For statistical data analysis was done with ANOVA, Bonferroni, Mann Whitney and Wil-coxon test. Results. The mean intensity of VEGF staining was statistically significantly higher in melanomas than in benign or dysplastic naevi. Furthermore, the highest re-corded values were in Ia and IV clinical stages. The majority of melanomas with high intensity of VEGF staining were in pT1a pathological stage. Melanomas with the highest mi-totic count (> 6) had a significantly higher intensity of VEGF staining than those with < 2 mitoses. The higest in-tensity of staining was in melanomas without significant lymphocytic infiltrate and the lowest was in those with brisk lymphocytic infiltrate, thus a statistical difference was sigini-fant. The mean intensity of VEGF staining was highest in melanomas with lymphovascular invasion. There was no statistically significant difference between VEGF and any other parameter. Conclusion. VEGF in primary skin mela-nomas plays an important role in tumor progression and is linked to the absence if tumor infiltrating lymphocytes and the presence of lymphovascular invasion. More detailed studies have to be done on VEGF prognostic value in melanoma on a larger number of patients.