Lack of Correlation Between Microvascular Density and Pathological Features and Outcomes in Sinonasal and Oral Mucosal Melanomas

Abstract

Unlike its cutaneous counterpart, prognostic markers for primary mucosal malignant melanoma have not been well elucidated. It has been recently demonstrated that microvascular density (MVD) in cutaneous malignant melanoma has a significant negative correlation with survival; however, this has not been well-studied in mucosal malignant melanoma of the head and neck. This study explores the potential association between MVD, various histological parameters, and the outcome of a series of sinonasal and oral mucosal melanomas. Nineteen such cases were immunostained with CD31 and the MVD was calculated by using Bioquant Image Analysis Software (R and M Biometrics, Nashville, TN). These cases included 16 sinonasal and 3 oral cavity tumors. The 1, 2, 3, 4 and 5 years overall survival rates were 75, 57, 61, 46 and 46%, respectively. The MVD of the tumors ranged from 25.7 to 732 vessels/mm 2 (mean 142.8 vessels/mm 2 ; median 84.7 vessels/mm 2 ). There was no significant correlation between the MVD and the different clinicopathological features seen within the tumors. There was also no correlation between the MVD and relapse free and overall survival. The results of this study suggest that MVD does not correlate with outcome in mucosal melanoma of the head and neck as seen in cutaneous melanomas. Further larger studies are needed to identify predictive and prognostic markers in such melanomas.

Prognostic value of S100/CD31 and S100/podoplanin double immunostaining in mucosal malignant melanoma of the head and neck

“…Although a high percentage of LVI and BVI in head and neck mucosal melanoma has been stated to be found in conventional histology before, their impact on prognosis of this rare disease has not been proven as statistically significant before . A more recent study even found no correlation between microvessel density and outcome in head and neck mucosal melanoma, but BVI was not analyzed in particular . This study is the first that presents detection of BVI by S100/CD31 double immunostaining in mucosal melanoma and was able to prove a significant prognostic impact on DSS time in head and neck mucosal melanoma.…”

“…24,42 A more recent study even found no correlation between microvessel density and outcome in head and neck mucosal melanoma, but BVI was not analyzed in particular. 43 This study is the first that presents detection of BVI by S100/ CD31 double immunostaining in mucosal melanoma and was able to prove a significant prognostic impact on DSS time in head and neck mucosal melanoma.…”

Angiogenesis‐related prognosis in patients with oral squamous cell carcinoma—role of the VEGF +936 C/T polymorphism

“…The case number of this series was similar if not higher compared with other studies analyzing a correlation between clinical OSCC parameters and MVD . To analyze a correlation between MVD and staining intensities, a Pearson's correlation coefficient was calculated.…”

“…These controversies concerning the value of MVD as prognostic parameter could be influenced by different methods of analysis such as immunohistochemistry and methods of assessment. Therefore, the method of evaluation was chosen to be simple, reproducible, and similar to prior publications . The monoclonal antibody anti‐CD31 is widely used for assessment of MVD and has shown to be better than staining by factor VII‐related antigen .…”

“…MVD was expressed as the mean number of vessels in three snapshots (0.2 mm 2 in area) per each sample at the magnification ×400. An additional quantification of the degree of CD31 staining was performed as described and conducted previously . In brief, the digitalized overview of each slide was opened in Photoshop (version 7; Adobe Systems, San Jose, CA, USA).…”