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Conjunctival melanoma: association of cyclooxygenase‐2 tumour expression to prognosis
Author(s) -
Pinto Proença R.,
Santos M.,
Fonseca C.,
Fernandes J.,
Gaspar M.F.,
Proença R.
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2017.03341
Subject(s) - medicine , immunohistochemistry , melanoma , pathological , pathology , tissue microarray , conjunctiva , proportional hazards model , oncology , metastasis , adjuvant therapy , cancer , cancer research
Purpose Conjunctival melanoma is a rare but potentially lethal tumour. Its biologic profile is still largely unknown, with recent studies aiming at establishing histopathological and genetic tumour profiles. The aim of this study was to analyse the association between clinicopathological characteristics and tumour expression of cyclooxygenase‐2 ( COX ‐2) to prognosis, assessing its usefulness as a possible prognostic marker. Methods Case series of 50 patients from 1991 to 2008 with pathologically proven conjunctival melanoma. Demographic, clinical and pathological characteristics were evaluated by reviewing clinical files and pathology. Expression of COX ‐2 was studied by immunohistochemistry of formalin‐fixed paraffin‐embedded tissue samples of 20 melanomas. Samples were classified in a score which included intensity of staining and percentage of cells with positive reactivity. Results Clinicopathological features significantly associated (p < .05) with a poor prognosis (death) included involvement of fornix and tarsal conjunctiva, tumour thickness exceeding 2 mm, local tumour recurrence, lymph node and systemic metastasis. In the immunohistochemistry study (n = 20) all cases expressed COX ‐2 although with different scores. However, only cases with score 4 were associated with a poor outcome. Multivariate association analysis revealed that recurrence rate, metastasis, corneal invasion and tumour thickness were associated with score 4 cases and, therefore, with a clinical profile with a higher risk of death. Conclusions Results suggest that higher COX ‐2 expression may be a negative prognostic factor in conjunctival melanoma. Further studies can address the potential use of anti‐ COX ‐2 drugs as adjuvant therapy of this disease.