Human leukocyte antigen Class II alleles associated with acral lentiginous melanoma in Mexican Mestizo patients: A case-control study

Background: Melanoma is an aggressive cutaneous cancer. Acral lentiginous melanoma is a melanoma subtype arising on palms, soles, and nail-units. The incidence, prevalence and prognosis differ among populations. The link between expression of major histocompatibility complex Class II alleles and melanoma progression is known. However, available studies report variable results regarding the association of melanoma with specific HLA Class II loci. Aims: The aim of the study was to determine HLA Class II allele frequencies in acral lentiginous melanoma patients and healthy Mexican Mestizo individuals. Methods: Eighteen patients with acral lentiginous melanoma and 99 healthy controls were recruited. HLA Class II typing was performed based on the sequence-specific oligonucleotide method. Results: Three alleles were associated with increased susceptibility to develop acral lentiginous melanoma, namely: HLA-DRB1*13:01; pC = 0.02, odds ratio = 6.1, IC95% = 1.4–25.5, HLA-DQA1*01:03; pC = 0.001, odds ratio = 9.3, IC95% = 2.7–31.3 and HLA-DQB1*02:02; pC = 0.01, odds ratio = 3.7, IC95% = 1.4–10.3. Limitations: The small sample size was a major limitation, although it included all acral lentiginous melanoma patients seen at the dermatology department of Dr. Manuel Gea González General Hospital during the study period. Conclusion: HLA-DRB1*13:01, HLA-DQB1*02:02 and HLA-DQA*01:03 alleles are associated with increased susceptibility to develop acral lentiginous melanoma in Mexican Mestizo patients.

Melanoma Classification from Dermoscopy Images Using Ensemble of Convolutional Neural Networks

Human skin is the most exposed part of the human body that needs constant protection and care from heat, light, dust, and direct exposure to other harmful radiation, such as UV rays. Skin cancer is one of the dangerous diseases found in humans. Melanoma is a form of skin cancer that begins in the cells (melanocytes) that control the pigment in human skin. Early detection and diagnosis of skin cancer, such as melanoma, is necessary to reduce the death rate due to skin cancer. In this paper, the classification of acral lentiginous melanoma, a type of melanoma with benign nevi, is being carried out. The proposed stacked ensemble method for melanoma classification uses different pre-trained models, such as Xception, Inceptionv3, InceptionResNet-V2, DenseNet121, and DenseNet201, by employing the concept of transfer learning and fine-tuning. The selection of pre-trained CNN architectures for transfer learning is based on models having the highest top-1 and top-5 accuracies on ImageNet. A novel stacked ensemble-based framework is presented to improve the generalizability and increase robustness by fusing fine-tuned pre-trained CNN models for acral lentiginous melanoma classification. The performance of the proposed method is evaluated by experimenting on a Figshare benchmark dataset. The impact of applying different augmentation techniques has also been analyzed through extensive experimentations. The results confirm that the proposed method outperforms state-of-the-art techniques and achieves an accuracy of 97.93%.

Protein expression of prognostic genes in primary melanoma and benign nevi

Purpose To evaluate the protein expression characteristics of genes employed in a recently introduced prognostic gene expression assay for patients with cutaneous melanoma (CM). Methods We studied 37 patients with CM and 10 with benign (melanocytic) nevi (BN). Immunohistochemistry of primary tumor tissue was performed for eight proteins: COL6A6, DCD, GBP4, KLHL41, KRT9, PIP, SCGB1D2, SCGB2A2. Results The protein expression of most markers investigated was relatively low (e.g., DCD, KRT9, SCGB1D2) and predominantly cytoplasmatic in melanocytes and keratinocytes. COL6A6, GBP4, and KLHL41 expression was significantly enhanced in CM when compared to BN. DCD protein expression was significantly correlated with COL6A6, GBP4, and KLHL41. GBP4 was positively correlated with KLHL41 and inversely correlated with SCGB2B2. The latter was also inversely correlated with serum S100B levels at time of initial diagnosis. The presence of SCGB1D2 expression was significantly associated with ulceration of the primary tumor. KRT9 protein expression was significantly more likely found in acral lentiginous melanoma. The presence of DCD expression was less likely associated with superficial spreading melanoma subtype but significantly associated with non-progressive disease. The absence of SCGB2A2 expression was significantly more often observed in patients who did not progress to stage III or IV. Conclusions The expression levels observed were relatively low but differed in part with those found in BN. Even though we detected some significant correlations between the protein expression levels and clinical parameters (e.g., CM subtype, course of disease), there was no major concordance with the protective or risk-associated functions of the corresponding genes included in a recently introduced prognostic gene expression assay.

Mechanistic Basis and Therapeutic Strategies in Immune Evasion in Cancer

One of the most popular types of skin cancer is acral lentiginous melanoma, which usually appears as an irregular, prominent growth on the palms of the hands, feet, or under the nails. In fact, the symptoms of this cancer, which is a prominent colored spot on the skin, slowly begin to appear. In the first stage, malignant cells remain inside the tissue for months or years. The lesion then acts aggressively and appears on the skin as it exits the epidermis. Experts say this type of melanoma can grow rapidly and penetrate deep into the skin. Unlike other skin cancers that occur due to overexposure to the sun, acral melanoma has nothing to do with it. In appearance, these types of cancer spots are more than 6 mm in size and can be brown, blue-gray, black or red. Early in the onset of the disease, the melanoma may have a smooth surface, but over time it becomes thicker and has a dry, uneven surface. Bleeding and sores on the cancerous spot are also possible in some cases. Now that we know that this type of cancer is not caused by the sun's rays, then what is the reason for its occurrence? Experts say our skin has natural pigments. However, melanoma linginosis develops when some malignant pigment cells begin to proliferate in the primary layers of the epidermis. Scientists do not yet know for sure why pigment cells become malignant, but it may be rooted in genetic mutations. When a doctor diagnoses skin cancer in a person, he or she removes the cancerous spots. This process can be more complicated depending on the size of the cancer cells. If the cancer has spread to the lymph nodes, the healing process will take longer. As with other cancers, early detection of skin cancer can speed up the healing process. Therefore, after seeing any spots or colored spots on the palms of your hands, feet or under your nails, see a specialist immediately. Keywords: Cancer; Cells; Tissues; Tumors; Prevention; Prognosis; Diagnosis; Imaging; Screening; Treatment; Management

Effect of changes in Breslow thickness between the initial punch biopsy results and final pathology reports in acral lentiginous melanoma patients

Acral lentiginous melanoma (ALM) is the most common subtype of cutaneous melanoma among Asians; punch biopsy is widely performed for its diagnosis. However, the pathologic parameters evaluated via punch biopsy may not be sufficient for predicting disease prognosis compared to the parameters evaluated via excisional biopsy. We investigated whether changes in Breslow thickness (BT) between initial punch biopsy results and final pathology reports can affect the prognosis of ALM. Pathologic parameters were recorded from specimens acquired through the initial punch biopsy and wide excision. Patients were classified into two groups based on a change in Breslow depth: the BT increased or decreased on comparing the samples from the initial punch biopsy and final wide excision. We compared clinical characteristics, and a Cox regression model was used to identify independent prognostic factors influencing melanoma-specific death (MSD). Changes in BT did not affect MSD (hazard ratio [HR]: 0.55, P = 0.447). In multivariate analysis, a higher BT (> 2 mm) (HR: 9.93, P = 0.046) and nodal metastasis (HR: 5.66, P = 0.041) were significantly associated with an increased MSD risk. The use of punch biopsy did not affect MSD despite the inaccuracy of BT measurement as long as ALM was accurately diagnosed.