DNA Level, Tumor Thickness, and Stereological Estimates of Nuclear Volume in Stage I Cutaneous Malignant Melanomas

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Abstract
The mutual relation and prognostic value of three quantitative variables were investigated in a retrospective series of 56 stage I cutaneous malignant melanomas. Unbiased stereological estimates of nuclear volume, nuclear JOURNAL/ajdr/04.02/00000372-199102000-00004/ENTITY_OV0456/v/2017-07-27T030131Z/r/image-pngv were obtained along with measurements of melanoma thickness. The DNA index (DI) was determined by flow cytometry in adjacent sections from the same paraffin-embedded specimens. The correlation between tumor thickness and nuclear JOURNAL/ajdr/04.02/00000372-199102000-00004/ENTITY_OV0456/v/2017-07-27T030131Z/r/image-pngv,. was only moderate (r = .60). Euploid lesions had a smaller nuclear JOURNAL/ajdr/04.02/00000372-199102000-00004/ENTITY_OV0456/v/2017-07-27T030131Z/r/image-pngv than aneuploid tumors (2p = .01), but with considerable overlap. No significant association between tumor thickness and DI could be demonstrated. Single-factor analysis showed prognostic value of nuclear JOURNAL/ajdr/04.02/00000372-199102000-00004/ENTITY_OV0456/v/2017-07-27T030131Z/r/image-pngv and tumor thickness (2p = .0007 and 2p = .03, respectively), whereas DI was without prognostic impact (2p = .54). When analyzing the three parameters in a Cox model, nuclear JOURNAL/ajdr/04.02/00000372-199102000-00004/ENTITY_OV0456/v/2017-07-27T030131Z/r/image-pngv was the only independent, prognostically significant variable. Physical, three-dimensional nuclear volume is not solely a reflection of nuclear DNA content, and may represent a valuable, quantitative prognostic indicator in cutaneous malignant melanomas.

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