Publication: Melanoma cutáneo en Guatemala: estudio morfológico inmunohistoquímico y detección de la mutación del gen BRAF
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2015-09-30
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Universidad Complutense de Madrid
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Abstract
El Melanoma cutáneo representa el tipo de cáncer de mas alta mortalidad entre los canceres cutáneos, aumentando alrededor de 5 % por año, de estos, entre un 85 y un 90% presentan melanomas en estadios tempranos y curables44.. En todo el mundo cada año se diagnostican cerca de 160,000 casos nuevos de melanoma y de acuerdo con la OMS cada año fallecen 57,000 personas. 34 La incidencia de melanoma para Europa es de 6-14 por 100,000 habitantes, en USA de 10 a 25 por 100,000 habitantes y en Australia y Nueva Zelandia es de 50 a 60 por 100,000 habitantes. 36,34. El objetivo del presente estudio fue determinar la proporción de casos de melanoma maligno cutáneo por morfología, inmunohistoquímica y mutación del gen BRAF en pacientes con diagnóstico de Melanoma en dos centros de referencia (INCAN e INDERMA) en la ciudad de Guatemala (2006 a 2011), recolectándose 100 casos de melanoma, los cuales fueron caracterizados por edad, sexo y localización anatomía del tumor. La proporción de nuevos casos de melanoma para el periodo estudiado fue de 5.5/1,000 del total de canceres reportados para el periodo establecido.. El sexo más afectado fue el femenino (53.54%) El grupo de edad con mayor numero de casos fue entre 56 a 75 anos (44% de los casos). El Melanoma Lentiginoso Acral (59%) fue el mas frecuente, con un predominio de la localización de la extremidad inferior (71%) (pie, región periungueal y artejos). No se encontraron casos de Melanoma Lentigo Maligno en los casos estudiados. El nivel de Clark que predomino en la población fue el nivel III. El Espesor de Breslow en el 59 % de los casos fue mayor de 1mm. El patrón de crecimiento de los casos que predomino fue el crecimiento vertical con un 75 % . La determinación de la mutación del Gen BRAF se encontró en un 6 % de la población en Melanoma de Extensión Superficial(33%) y el Melanoma Nodular (50%). Sólo en un caso de melanomas de mucosas (17%) se demostró la mutación. En el Melanoma Lentigo Acral no se demostró la mutación.
Melanoma skin cancer is the one with the highest mortality over the skin cancers, increasing about 5% per year, of these, between 85 and 90% of melanomas occur in early stages and curables 44 .. Worldwide, each year about 160,000 new cases of melanoma, are diagnosed . According to WHO about 57,000 people die each year. 34 The incidence of melanoma in Europe is 6 to 14 per 100,000 population, in USA 10 to 25 per 100,000, and in Australia and New Zealand is 50 to 60 per 100,000 population.36.34. The aim of this study was to determine the proportion of cases of cutaneous malignant melanoma by morphology, immunohistochemistry and BRAF gene mutation in patients with melanoma in two reference hospitals (INCAN and INDERMA) in Guatemala City (2006-2011) ,100 cases of melanoma were collected, characterized by age, sex and location of the tumor. The proportion of new cases of melanoma for the study period was 5.5 / 1,000 of all cancers reported for the period from 2006 to 2011 .. The most affected sex was female (53.54%), compare to male. The age group with the highest number of cases was between 56-75 years (44%). Acral lentiginous melanoma (59%) was the most frequent, with a predominance of the location of the lower extremity (71%) (foot, knuckles and periungual region). There were no cases of lentigo malignant melanoma. Clark level that prevailed in the population was the level III. The Breslow thickness in 59% of cases was greater than 1 mm. The growth pattern of the cases predominant was the vertical growth with 75%. The determination of the BRAF gene mutation was found in 6% of the population: superficial Spreading Melanoma (33%), Nodular Melanoma (50%). Only one case of Mucosal Melanoma (17%) showed the mutation. Acral Lentiginous Melanoma showed no mutation.
Melanoma skin cancer is the one with the highest mortality over the skin cancers, increasing about 5% per year, of these, between 85 and 90% of melanomas occur in early stages and curables 44 .. Worldwide, each year about 160,000 new cases of melanoma, are diagnosed . According to WHO about 57,000 people die each year. 34 The incidence of melanoma in Europe is 6 to 14 per 100,000 population, in USA 10 to 25 per 100,000, and in Australia and New Zealand is 50 to 60 per 100,000 population.36.34. The aim of this study was to determine the proportion of cases of cutaneous malignant melanoma by morphology, immunohistochemistry and BRAF gene mutation in patients with melanoma in two reference hospitals (INCAN and INDERMA) in Guatemala City (2006-2011) ,100 cases of melanoma were collected, characterized by age, sex and location of the tumor. The proportion of new cases of melanoma for the study period was 5.5 / 1,000 of all cancers reported for the period from 2006 to 2011 .. The most affected sex was female (53.54%), compare to male. The age group with the highest number of cases was between 56-75 years (44%). Acral lentiginous melanoma (59%) was the most frequent, with a predominance of the location of the lower extremity (71%) (foot, knuckles and periungual region). There were no cases of lentigo malignant melanoma. Clark level that prevailed in the population was the level III. The Breslow thickness in 59% of cases was greater than 1 mm. The growth pattern of the cases predominant was the vertical growth with 75%. The determination of the BRAF gene mutation was found in 6% of the population: superficial Spreading Melanoma (33%), Nodular Melanoma (50%). Only one case of Mucosal Melanoma (17%) showed the mutation. Acral Lentiginous Melanoma showed no mutation.
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Anatomía Patológica, leída el 01-07-2013