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- Title
INSIGHTS INTO MELANOMA HISTOLOGICAL ASPECTS, PROGRESSION AND PROGNOSTIC.
- Authors
SASS, CAMELIA; BOJIN, FLORINA; DEHELEAN, CRISTINA; SOICA, CODRUTA; PAUNESCU, VIRGIL
- Abstract
Melanoma, a malignant tumor of melanocytes, is the most aggressive form of skin cancer and its frequency is increasing in all Caucasian skin populations. The strongest risk factors are family history of melanoma, multiple pre-existent melanocytic nevi, previous melanoma, previous nonmelanoma skin cancer. Based on the histological features, primary cutaneous melanomas have been classified in four types. The major histologic subtypes of melanoma are superficial spreading melanoma, nodular melanoma, lentigo melanoma and acral lentiginous melanoma. Early diagnosed, melanoma has a good prognosis, beeing completely cured in the early stage by operation. In order to facilitate the early recognition of potentially curable cutaneous malignant melanoma, the ABCDE acronym is a easy tool provided. The Clinical features described are: Asymmetry, Border irregularity, Color variegation, Diameter greater than 6 mm and Evolving, which recognize the dynamic nature of the skin malignacy. During the melanomogenesis process, histological changes are accompanied by biological events, molecular lesions and genetic alterations. Starting with the formation of benign nevus, and then progressing to the junctional melanocytic hyperplasia and then aberrant differentiation, a mutation of BRAF gene and activation of the MAPK signaling pathway take place. Progression to the radial growth phase is accompanied by loss of CDKN24 and loss of PTEN. The switch from radial growth phase to vertical growth phase is the most crucial step in melanoma tumorigenesis, commonly associated with subsequent metastatic disease. Loss of E-cadherin and expression of N-cadherin, mutation in BRAF and NRAS genes are events that mark this progression. Also associated events are loss of two transcription factors, activator protein-2a (AP-2a) and cAMP response element binding protein (CREB). The metastatic melanoma is the last stage, when the metastatic tumor enter the lymphatic and blood circulation and metastasize to other organs like lymph nodes, brain, liver or lung. Galentin-3 and Galentin-1, are two members of galentin family which are directly corelated with the metastatic potential of melanomas. The review seeks to examine melanoma progression and some molecular changes that accompanied the process. Also, a histologic classification and prevention and early recognition of melanoma are beeing discussed.
- Subjects
MELANOMA; DISEASE progression; CANCER prognosis
- Publication
Physiology / Fiziologia, 2013, Vol 23, Issue 3, p14
- ISSN
1223-2076
- Publication type
Article