Ki-67 staining pattern as a prognostic biomarker for advanced acral melanoma

IF 4.4 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia Pub Date : 2026-03-01 Epub Date: 2026-03-19 DOI:10.1016/j.abd.2026.501298

Marcel Arakaki Asato , Isabeli Joaquim Contel , Francisco Alves Moraes Neto , Juliana Polizel Ocanha-Xavier , Nathália Silva Carlos Oliveira , Maxwell A. Fung , Mariangela Esther Alencar Marques , José Cândido Caldeira Xavier-Júnior

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引用次数: 0

Abstract

Background

Acral cutaneous melanoma (ACM) is an aggressive skin cancer, especially when diagnosed in the advanced stage. The Ki-67 is a rapid tool for proliferation rate analysis. Previous data indicated that its staining pattern is distinct during the several stages of the cell cycle among epithelial cells.

Objective

To evaluate the prognostic impact of Ki-67 expression pattern classification among advanced acral cutaneous melanoma cases.

Methods

Two pathologists classified staining nuclear patterns of Ki-67 in the hot spot of scanning slides of advanced ACM (pT4): NP1 (randomly Ki-67 immunopositive fine or coarse granules), NP2 (Ki-67 stained in one or two well defined and centralized nodules), NP3 (Ki-67 seen as granules or nodules occupying most of the nucleus), NP4 (nucleoplasm with intense and homogeneous Ki-67 staining) and NP5 (empty central area with peripheral Ki-67). For analysis, seven cases per group ‒ Alive (Al) and Melanoma-Related Death (De) ‒ were randomly selected.

Results

This pilot study analyzed 5676 Ki-67 positive nuclei. Means comparison between the two groups revealed differences in nuclear patterns NP1 (p = 0.0014), NP4 (p = 0.038), NP5 (p = 0.0193), and the total number of stained nuclei (p = 0.0258).

Study limitations

Small number of cases and biased value of 6.35 through the Bland-Altman analysis.

Conclusion

The present analysis highlights the importance of Ki-67 staining patterns as a potential prognostic marker among ACM. High Ki-67 positive nuclei were associated with worse outcomes (death), particularly in staining patterns before and after mitosis (NP1, NP4, and NP5).

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Ki-67染色模式作为晚期肢端黑色素瘤的预后生物标志物。

背景：肢端皮肤黑色素瘤（Acral skin melanoma， ACM）是一种侵袭性皮肤癌，尤其是在晚期诊断时。Ki-67是一种快速的增殖率分析工具。以往的研究表明，在上皮细胞中，其染色模式在细胞周期的几个阶段是不同的。目的：探讨Ki-67表达谱分型对晚期肢端皮肤黑色素瘤患者预后的影响。方法：两名病理学家将晚期ACM扫描切片热点区Ki-67染色核模式分为：NP1（随机Ki-67免疫阳性的细粒或粗粒）、NP2 （Ki-67染色一两个明确集中的结节）、NP3 （Ki-67可见颗粒或结节占据大部分细胞核）、NP4 （Ki-67染色强烈均匀的核质）和NP5（周围有Ki-67的空中心区域）。为了进行分析，每组随机选择7例——存活（Al）和黑色素瘤相关死亡（De）。结果：本初步研究分析了5676个Ki-67阳性细胞核。两组间的均值比较显示NP1 （p = 0.0014）、NP4 （p = 0.038）、NP5 （p = 0.0193）和染色细胞核总数（p = 0.0258）的差异。研究局限性：病例数少，Bland-Altman分析偏倚值为6.35。结论：目前的分析强调了Ki-67染色模式作为ACM潜在预后标志物的重要性。高Ki-67阳性细胞核与较差的预后（死亡）相关，特别是有丝分裂前后的染色模式（NP1， NP4和NP5）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anais brasileiros de dermatologia DERMATOLOGY-

CiteScore

2.40

自引率

0.00%

发文量

184

审稿时长

32 days

期刊介绍： The journal is published bimonthly and is devoted to the dissemination of original, unpublished technical-scientific study, resulting from research or reviews of dermatological topics and related matters. Exchanges with other publications may be accepted.