Summary
1α-Hydroxylase (CYP27B1), the enzyme responsible for the synthesis of the biologically active form of vitamin D (1,25(OH)2D3), is expressed in the skin. To assess the correlation between progression of melanocytic tumors and CYP27B1, we analyzed its expression in 29 benign nevi, 75 primary cutaneous melanomas, 40 metastases, and 4 re-excision and 6 normal skin biopsies. Immunoreactivity for CYP27B1 was significantly lower in the vertical growth phase (VGP) and metastatic melanomas (0.6 and 0.5 arbitrary units [AU], respectively) in comparison with nevi and radial growth phase (RGP) tumors (1.2 and 1.1 AU, respectively); and expression was reduced in more advanced lesions (Clark levels III–V, Breslow thickness ≥2.1 mm; 0.8 and 0.7 AU, respectively). There was an inverse correlation between CYP27B1 and Ki-67 expression. Furthermore, CYP27B1 expression was reduced in primary melanomas that created metastases in comparison with non-metastasizing melanomas. Reduced CYP27B1 expression in RGP was related to shorter overall survival (810 vs 982 vs 1151 days in melanomas with absent, low, and high CYP27B1 immunoreactivity), and low CYP27B1 expression in RGP and VGP was related to shorter disease-free survival (114 vs 339 vs 737 days and 129 vs 307 vs 737 days, respectively, in melanomas with absent, low, and high CYP27B1). Also, CYP27B1 expression was inversely related to melanin in melanoma cells in vivo and melanoma cells cultured in vitro. Thus, reduction of CYP27B1 correlates with melanoma phenotype and behavior, and its lack affects the survival of melanoma patients, indicating a role in the pathogenesis and progression of this cancer.