Identification And Clinical Evaluation Of Senescence Associated Markers To Distinguish Melanocytic Nevi From Melanomas
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Author | : Kyriakos Orfanidis |
Publisher | : Linköping University Electronic Press |
Total Pages | : 106 |
Release | : 2019-12-19 |
Genre | : |
ISBN | : 9179299261 |
Melanoma is a form of cancer that develops in melanocytes. While it represents only 5% of skin malignancies, it is the most aggressive and lethal. Benign proliferation of these cells form the melanocytic nevi. The definitive diagnosis of melanocytic nevi or melanoma lesions is histopathologic. However, it is estimated that a correct diagnosis is established by means of standard skin biopsy in only 83% of the melanocytic lesions; of the remaining cases 8% and 9% are overinterpreted (false positives) and under-interpreted (false negatives), respectively. This underscores the importance of additional diagnostic tests. Since cellular senescence is considered to be a tumor suppressive mechanism, immuno-histochemistry using senescence markers has been suggested for the evaluation of difficult melanocytic lesions; however, the routinely used senescence markers lack the ability to distinguish nevi from melanoma. The general aim of this thesis is therefore to identify novel senescence markers that may aid in melanoma diagnosis. In study I, we established a cellular model with nevus-mimicking characteristics consisting in primary melanocytes that become senescent. Transcriptomic analysis allowed expanding the set of senescence-associated markers that could distinguish nevi from melanoma and identifying tubulin ?-3 as a potential diagnostic marker. Depletion of tubulin ?-3 and pretreatment with tubulin destabilizing drugs in melanocytes and melanoma cells induced a senescence-like phenotype in vitro. In particular, reduced migration capacity and induction of cell cycle arrest in G2/M phase of the cell cycle was demonstrated. In study II, a potential inter-cellular signaling pathway between melanoma cells and stromal fibroblasts, that might facilitate melanoma invasion, was investigated. Ultraviolet (UV) radiation was shown, both in melanoma cells and fibroblasts, to promote the release and activation of TGF-?1 and subsequent increase in expression of the serine protease FAP-?, a protein that plays role in extracellular matrix degradation and therefore facilitates the invasion of melanoma cells. Such mechanism was not functional in senescent melanocytes. In study III, it was shown that tubulin ?-3 immunostaining aids in the diagnosis of nevi and melanomas. The diagnostic criterium was the tubulin ?-3 gradient within the melanocytic nevi that was no longer apparent in melanoma. Different patterns of tubulin ?-3 immunostaining in melanoma were described, dermoscopy-immunohistochemistry associations were found, specific dermoscopic features highlighted, and the prognostic value of this tubulin ?-3 marker was examined. The progression rate in patients whose melanomas had areas with loss of tubulin ?-3 was 4 times higher than in patients without this feature, although statistical significance could not be reached (p=0.06). In conclusion, transcriptomic analysis expanded the set of senescence-associated markers that could distinguish nevi from melanoma and identified tubulin ?-3 as novel immunohistochemistry marker shown to have diagnostic and probably prognostic value. From a mechanistical point of view, ultraviolet radiation was shown to promote not only the formation of melanoma but also its progression by increasing a cathepsin-TGF-?1-FAP-? pathway resulting in extracellular matrix degradation. Malignt melanom är en form av cancer som utvecklas i melanocyter, de celler i huden som bildar pigmentet melanin. Även om malignt melanom endast utgör 5% av alla hudcancrar, är den den mest aggressiva och dödliga. Godartad ansamling av melanocyter bildar en leverfläck eller ett sk nevus. Vid minsta misstanke om melanom, opereras nevuset bort och analyseras i mikroskop. Det uppskattas dock att en korrekt diagnos fastställs endast i 83% av de bortopererade lesionerna. Av de återstående fallen är 8% övertolkade och 9% undertolkade. Detta understryker vikten av att förbättra melanomdiagnostik. Melanocyter i nevi anses i motsats till melanom ha avtagande förmåga att föröka sig efter ett visst antal celldelningar på grund av cellåldrande. Påvisande av cellåldrande-markörer skulle därför kunna förbättra diagnostiken av svårbedömda lesioner. De idag rutinmässigt använda cellåldrande-markörerna saknar dock förmåga att skilja nevi från melanom. Det övergripande syftet med denna avhandling var därför att försöka identifiera nya cellåldrande-markörer för att förbättra melanom-diagnostiken. I studie I etablerade vi en cellmodell med nevus-efterliknande egenskaper bestående av melanocyter som åldras. Med genuttryck-analys studerades cellåldrande-markörer som kunde skilja nevi från melanom. Proteinet tubulin ?-3 identifierades som en potentiell diagnostisk markör. Minskning av tubulin ?-3 och förbehandling med tubulin-destabiliserande läkemedel i melanocyter visade sig inducera ett tillstånd som liknar cellåldrandet. I studie II undersöktes en signalväg mellan melanomceller och fibroblaster, som kan underlätta melanomcellers förmåga att infiltrera och aktivt förstöra omgivande vävnad. Fibroblaster är en typ av bindvävsceller i läderhuden som tillverkar ämnen som finns mellan celler, s.k. extracellulär matrix. Ultraviolett (UV)-strålning visade sig, både i melanomceller och fibroblaster, främja signalvägen som resulterar i ökat proteinuttryck av FAP-?, ett protein som bidrar till nedbrytning av extracellulär matrix vilket kan underlätta infiltration av melanomceller. En sådan signalväg var inte funktionell i åldrande melanocyter. I studie III visade vi att proteinet tubulin ?-3 är en markör som underlättar diagnostik av nevi respektive melanom. Det diagnostiska kriteriet var tubulin ?-3 gradienten som kunde ses i nevi men som ej var synligt i melanom. Olika mönster av tubulin ?-3 analys i melanom beskrevs, kliniska associationer hittades och värdet av denna markör för att förutsäga sjukdomens förlopp undersöktes. Melanompatienter, vars melanom hade områden med förlust av tubulin ?-3, hade fyra gånger högre progressionstakt av sjukdomen jämfört med patienter utan detta mönster. Sammanfattningsvis studerade vi cellåldrande-markörer som kunde skilja nevi från melanom och vi identifierade proteinet tubulin ?-3 som en markör med diagnostiskt och förmodligen prognostiskt värde. Vi visade att ultraviolett strålning inte bara främjar melanombildning utan också dess progression genom att öka en signalväg mellan melanomceller och fibroblaster som resulterar i extracellulär matrixnedbrytning.
Author | : Charles M. Balch |
Publisher | : Springer |
Total Pages | : 0 |
Release | : 2020-01-29 |
Genre | : Medical |
ISBN | : 9783030050689 |
Written by the leading melanoma experts from the United States, Australia, and Europe, this new edition incorporates the clinical outcomes of more than 70,000 patients treated at major melanoma centers throughout the world and is the definitive and most authoritative textbook on melanoma used worldwide. Providing the most up-to-date and comprehensive information needed for the clinical management and scientific study of melanoma, Cutaneous Melanoma, 6th edition covers everything from precursors of melanoma to advanced stages of metastatic disease.
Author | : Rhoda M. Alani |
Publisher | : Springer Nature |
Total Pages | : 354 |
Release | : 2021-11-26 |
Genre | : Medical |
ISBN | : 3030826392 |
This book provides a concise practical guide to melanoma enabling the reader to develop a thorough understanding of the etiology, pathogenesis, diagnosis, treatment and prevention of melanoma. It features easy to digest instructional text that describes a variety of techniques for detecting and staging melanoma including total body photography. Surgical, radiation and systemic therapy treatment options as well as prevention strategies are also covered. Melanoma in Clinical Practice represents a thorough guide on how to diagnose treat and prevent melanoma, and provides a valuable resource for the trainee and experienced clinical dermatologists who are seeking a reference guide to use in their clinical practice.
Author | : Ashfaq A. Marghoob |
Publisher | : Springer Science & Business Media |
Total Pages | : 160 |
Release | : 2012-10-13 |
Genre | : Medical |
ISBN | : 3642283977 |
The “Abtropfung” theory that nevi develop through the migration of nevus cells from the epidermis to the dermis prevailed for almost a century until the “Hochsteigerung” theory postulated the reverse pattern of migration. Most recently, however, new insights gained from epidemiology, cross-sectional and longitudinal studies of nevi, dermoscopy and confocal microscopy, and cellular and molecular studies have brought into question both of these theories. This book provides a comprehensive guide to current knowledge about nevogenesis by presenting these latest advances and in addition discusses issues yet to be resolved. It will assist practicing physicians in effectively managing patients with a variety of nevi and will also be of great value to researchers in the field. Importantly, since nevi are associated with an increased risk of melanoma, understanding nevogenesis may help to unravel some of the mysteries of melanomagenesis.
Author | : Guido Massi |
Publisher | : Springer Science & Business Media |
Total Pages | : 764 |
Release | : 2013-09-16 |
Genre | : Medical |
ISBN | : 3642373119 |
The interpretation of melanocytic tumors represents probably the most difficult task in the field of dermatopathology. The second edition of this text and atlas depicts a broad range of the most important and most challenging melanocytic lesions. Each individual case is illustrated with at least three high-quality color photographs and is commented on at length, highlighting the diagnostic clues. The goal of the authors is to assist the ordinary pathologist in making a precise workable diagnosis in their daily practice. They achieve this by providing simple criteria that will serve as a sound basis for an unequivocal diagnosis of either a benign or a malignant melanocytic neoplasm. The reader will find Histological Diagnosis of Nevi and Melanoma to be an invaluable guide to correct diagnosis even in difficult or rare cases.
Author | : Mai P. Hoang |
Publisher | : Springer |
Total Pages | : 482 |
Release | : 2014-06-26 |
Genre | : Medical |
ISBN | : 149390891X |
Melanocytic Lesions: A Case Based Approach provides a concise yet comprehensive guideline on how to diagnose common as well as problematic and challenging melanocytic lesions. In the first 11 chapters, each entity is illustrated by an actual case; followed by discussion of how the diagnosis is reached, of the histologic differential diagnoses and of diagnostic pitfalls and ends with bulleted teaching points. Pertinent and up to date references are included at the end of each chapter. The latter chapters cover current microstaging and classification of melanoma, ancillary techniques including immunohistochemistry as well as available molecular assays and molecular targeted therapy. All figures and glass slides of the discussed cases are hosted online for easy viewing and access. Melanocytic Lesions: A Case Based Approach will serves as a useful resource for pathologists, dermatologists and researchers dealing with melanocytic lesions.
Author | : Giuseppe Argenziano |
Publisher | : Academic Press |
Total Pages | : 254 |
Release | : 2017-08-15 |
Genre | : Medical |
ISBN | : 0128040319 |
Cutaneous Melanoma: A Pocket Guide for Diagnosis and Management serves as an easy-to-consult, short, and schematic reference providing guidelines for diagnosing and managing melanoma in the context of various clinical scenarios. In the daily routine of a busy clinician, there is a need for schematic reference tools that allow quick consultation for immediate decisions. Melanoma is a deadly disease that should be promptly managed following precise and evidence-based guidelines. The guide contains many schematics and figures, vastly outnumbering the pages dedicated to text. This guide follows the sequence of a real clinical setting, going from the first screening visit to the final stages of terminal patients. - Provides a quick-access resource for diagnosis and treatment of melanoma patients at all stages - Includes succinct guidelines, schematics, and figures for busy clinicians - Concludes with a section addressing special clinical situations, including melanoma in pregnancy, pediatric melanoma, familial melanoma and MPM, atypical Spitz tumor, occult primary melanoma, and the histopathologic gray zone
Author | : International Academy of Pathology |
Publisher | : IARC |
Total Pages | : 364 |
Release | : 2006 |
Genre | : Medical |
ISBN | : 9789283224143 |
Pathology and Genetics of Skin Tumours is the latest volume in the new WHO series on histological and genetic typing of human tumours. This publication, offers an authorative and concise reference book, providing an international standard for dermatologists, pathologists and oncologists and will serve as an indispensable guide for use in the design of studies monitoring response to therapy and clinical outcome. Diagnostic criteria, pathological features, and associated genetic alterations are described in strictly disease-oriented manner. Sections on all WHO-recognized neoplasms and their variants include ICD-O codes, incidence, age and sex distribution, location, clinical signs and symptoms, pathology, genetics, and predictive factors. The book, prepared by more than 150 authors from 20 countries, contains 648 colour photographs, clinical images and charts, amd more than 2600 references. This volume covers keratinocytic, melanocytic, appendageal, haematopoietic, soft tissue and neural tumours, as well as inherited tumour syndromes. Each entity is extensively discussed with information on clinicopathological, epidemiological, immunophenotypic and genetic aspects of these diseases.
Author | : J. Eduardo Calonje |
Publisher | : Elsevier Health Sciences |
Total Pages | : 2723 |
Release | : 2018-10-29 |
Genre | : Medical |
ISBN | : 0702075523 |
Comprehensive and lavishly illustrated, McKee's Pathology of the Skin, 5th Edition, is your reference of choice for up-to-date, authoritative information on dermatopathology. You'll find clinical guidance from internationally renowned experts along with details on etiology, pathogenesis, histopathology, and differential diagnosis – making this unique reference unparalleled in its wealth of clinical and histopathological material. The 5th Edition of this classic text is a must-have resource for practicing dermatopathologists and general pathologists who sign out skin biopsies. - Covers pathological aspects of skin diseases in addition to providing superb descriptions and illustrations of their clinical manifestations – the only available reference with this unique combination of features. - Integrates dermatopathology, clinical correlations, and clinical photographs throughout, and features bulleted lists of clinical features and differential diagnosis tables for easy reference. - Contains more than 5,000 superb histopathologic and clinical illustrations that demonstrate the range of histologic manifestations. - Brings you fully up to date with key molecular aspects of disease, the capabilities and limitations of molecular diagnostics, and targeted/personalized medicine. - Features up-to-date information on biologics, drug eruptions, and other developments in therapeutics. - Helps you stay current with the latest diagnostic tumor markers and other new developments in immunohistochemistry. - Includes a completely revised chapter on cutaneous lymphoma that reflects recent WHO-EORTC classification changes, as well as new coverage of sentinel lymph node biopsy for melanoma. - Shares the knowledge of the main editor Dr. J. Eduardo Calonje, along with co-editors Thomas Brenn, and Alexander Lazar, and new co-editor Steven D. Billings who offers expertise on both dermatopathology and soft tissue tumors. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
Author | : Miroslav Blumenberg |
Publisher | : BoD – Books on Demand |
Total Pages | : 214 |
Release | : 2018-05-02 |
Genre | : Medical |
ISBN | : 1789230942 |
Human skin cancers, the most common type of tumors, represent a significant health burden. The deadliest is unquestionably melanoma. Half of melanomas have an activating mutation in the BRAF gene, prompting development of novel drugs, vemurafenib and dabrafenib, specifically targeting mutated BRAF. Trametinib and cobimetinib, which block MEK, a BRAF effector protein, have been used in combination with BRAF inhibitors. A promising new melanoma treatment is immunotherapy, approach that boosts patient's own immune system to attack cancer. Pembrolizumab and nivolumab inhibit PD-1, whereas Ipilimumab targets CTLA-4, another immunity check point, to boost the immune response. Here we focus on pathways, mechanisms, targets and treatments of human skin cancers, with particular emphasis on the new developments in the research on melanomas.