The intermediate filament
nestin, a neural stem-cell marker, is reported to be expressed more strongly in
melanomas compared with benign melanocytic lesions, and increasingly expressed in advanced
melanoma stages. However, the prognostic impact of
nestin on
melanoma has not been well elucidated. The aim of the present study was to evaluate the prognostic influence of
nestin expression in cutaneous
melanoma in comparison with standard clinico-pathologic variables. In a large series of nodular cutaneous
melanoma (n=348),
nestin expression was assessed by immunohistochemistry using tissue microarray (TMA) sections. For comparison,
nestin staining in corresponding
metastases as well as in superficial spreading
melanomas and benign
nevi was also examined.
Nestin was expressed to varying degrees in a majority of nodular
melanomas (92%), and was significantly associated with increased
tumor thickness, high mitotic count, and the presence of ulceration and
tumor necrosis. Also, expression was stronger in the nodular type than in superficial spreading
melanomas and benign
nevi, but without significant difference when compared with matched
metastases from the former. Importantly, strong expression of
nestin was significantly associated with reduced survival in multivariate analysis. In conclusion, increased
nestin expression was associated with aggressive
melanoma features, with independent prognostic impact on multivariate survival analysis when compared with clinico-pathologic factors.