Avaliação da expressão de HMGBI em pacientes com melanoma cutâneos primários: associação com parâmetros clínicos e patológicos

Abstract

Introduction: Primary melanoma is considered one of the most lethal primary skin cancers. Cell signaling disturbances contribute to the pathogenesis of this cancer, and genetic expressions of such markers have been ostensibly studied. Therefore, investigating melanoma cell proliferation is essential to understand tumor promotion and progression mechanisms. The HMGB1 protein is associated with cell proliferation and metastases development. Aim: To evaluate HMGB1 expression in patients with melanoma and its correlation with clinical and pathological parameters. Methodology: This is a retrospective and observational study. We included seventy-three subjects with primary melanoma treated at Hospital Haroldo Juaçaba from 2011 to 2016. Clinical and pathological data were obtained from electronic medical records. We built a Tissue Microarray (TMA) from paraffin-embedded primary tumor samples (FFPE) to evaluate the HMGB1 expression by the Indirect Immunofluorescence (IFI) technique. Then, the SPSS software version 20.0 was used for the statistical analysis. We set p<0.05 as a statistically significant difference. Ethics Committee approval number 5726981. Results: We evaluated 82 cases of primary cutaneous melanomas in 73 patients. 63.42% were female, and 36.58% were male, with a median age of 56. Concerning skin layer invasion criteria or Clark's scale, the most frequent invasion levels were IV and V, meaning 36.59% and 19.51%, respectively. In the histopathological examination, the presence of ulceration was recorded in 40.24% of subjects. Additionally, Clark's scale indicated significant skin invasion (p=0.0432), positively associated with HMGB1 expression. We also found a statistical significance (p<0.05) between low HMGB1 expression and ulceration or Breslow's index. Conclusion: The low expression of HMGB1 showed a significant correlation with clinical and pathological parameters, such as Clark's and Breslow's scales and ulceration scores.