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Issues affecting molecular staging in the management of patients with melanoma.

Palmieri G, Casula M, Sini MC, Ascierto PA, Cossu A - J. Cell. Mol. Med. (2007 Sep-Oct)

Bottom Line: Detection of occult melanoma cells in peripheral blood (circulating metastatic cells [CMC]) or in sentinel lymph nodes (sentinel node metastatic cells [SNMC]), could significantly contribute to better predict survival in melanoma patients.Increasing evidence suggest that melanoma develops as a result of accumulated abnormalities in genetic pathways within the melanocytic lineage.The different molecular mechanisms may have separate roles or cooperate during all evolutionary phases of melanocytic tumourigenesis, generating different subsets of melanoma patients with distinct aggressiveness, clinical behaviour, and response to therapy.

View Article: PubMed Central - PubMed

Affiliation: Istituto di Chimica Biomolecolare, Consiglio Nazionale delle Ricerche, Li Punti-Sassari, Italy. gpalmieri@yahoo.com

ABSTRACT
Prediction of metastatic potential remains one of the main goals to be pursued in order to better assess the risk subgroups of patients with melanoma. Detection of occult melanoma cells in peripheral blood (circulating metastatic cells [CMC]) or in sentinel lymph nodes (sentinel node metastatic cells [SNMC]), could significantly contribute to better predict survival in melanoma patients. An overview of the numerous published studies indicate the existence of several drawbacks about either the reliability of the approaches for identification of occult melanoma cells or the clinical value of CMC and SNMC as prognostic factors among melanoma patients. In this sense, characterization of the molecular mechanisms involved in development and progression of melanoma (referred to as melanomagenesis) could contribute to better classify the different subsets of melanoma patients. Increasing evidence suggest that melanoma develops as a result of accumulated abnormalities in genetic pathways within the melanocytic lineage. The different molecular mechanisms may have separate roles or cooperate during all evolutionary phases of melanocytic tumourigenesis, generating different subsets of melanoma patients with distinct aggressiveness, clinical behaviour, and response to therapy. All these features associated with either the dissemination of occult metastatic cells or the melanomagenesis might be useful to adequately manage the melanoma patients with different prognosis as well as to better address the different melanoma subsets toward more appropriate therapeutic approaches.

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Related in: MedlinePlus

Proposed model of melanocytic tumourigenesis. The main molecular alterations underlying each step from melanocytic proliferation to advanced melanoma are indicated.
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Related In: Results  -  Collection


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fig03: Proposed model of melanocytic tumourigenesis. The main molecular alterations underlying each step from melanocytic proliferation to advanced melanoma are indicated.

Mentions: All these findings clearly indicate the existence of a complex molecular machinery that provides checks and balances in normal melanocytes. Progression from normal melanocytes to malignant metastatic cell in melanoma patients is the result of a combination of down- or up-regulations of the various effectors acting into the different molecular pathways (Fig. 3). The main interactions underlying the melanomagen-esis could be summarized as follow.


Issues affecting molecular staging in the management of patients with melanoma.

Palmieri G, Casula M, Sini MC, Ascierto PA, Cossu A - J. Cell. Mol. Med. (2007 Sep-Oct)

Proposed model of melanocytic tumourigenesis. The main molecular alterations underlying each step from melanocytic proliferation to advanced melanoma are indicated.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4401272&req=5

fig03: Proposed model of melanocytic tumourigenesis. The main molecular alterations underlying each step from melanocytic proliferation to advanced melanoma are indicated.
Mentions: All these findings clearly indicate the existence of a complex molecular machinery that provides checks and balances in normal melanocytes. Progression from normal melanocytes to malignant metastatic cell in melanoma patients is the result of a combination of down- or up-regulations of the various effectors acting into the different molecular pathways (Fig. 3). The main interactions underlying the melanomagen-esis could be summarized as follow.

Bottom Line: Detection of occult melanoma cells in peripheral blood (circulating metastatic cells [CMC]) or in sentinel lymph nodes (sentinel node metastatic cells [SNMC]), could significantly contribute to better predict survival in melanoma patients.Increasing evidence suggest that melanoma develops as a result of accumulated abnormalities in genetic pathways within the melanocytic lineage.The different molecular mechanisms may have separate roles or cooperate during all evolutionary phases of melanocytic tumourigenesis, generating different subsets of melanoma patients with distinct aggressiveness, clinical behaviour, and response to therapy.

View Article: PubMed Central - PubMed

Affiliation: Istituto di Chimica Biomolecolare, Consiglio Nazionale delle Ricerche, Li Punti-Sassari, Italy. gpalmieri@yahoo.com

ABSTRACT
Prediction of metastatic potential remains one of the main goals to be pursued in order to better assess the risk subgroups of patients with melanoma. Detection of occult melanoma cells in peripheral blood (circulating metastatic cells [CMC]) or in sentinel lymph nodes (sentinel node metastatic cells [SNMC]), could significantly contribute to better predict survival in melanoma patients. An overview of the numerous published studies indicate the existence of several drawbacks about either the reliability of the approaches for identification of occult melanoma cells or the clinical value of CMC and SNMC as prognostic factors among melanoma patients. In this sense, characterization of the molecular mechanisms involved in development and progression of melanoma (referred to as melanomagenesis) could contribute to better classify the different subsets of melanoma patients. Increasing evidence suggest that melanoma develops as a result of accumulated abnormalities in genetic pathways within the melanocytic lineage. The different molecular mechanisms may have separate roles or cooperate during all evolutionary phases of melanocytic tumourigenesis, generating different subsets of melanoma patients with distinct aggressiveness, clinical behaviour, and response to therapy. All these features associated with either the dissemination of occult metastatic cells or the melanomagenesis might be useful to adequately manage the melanoma patients with different prognosis as well as to better address the different melanoma subsets toward more appropriate therapeutic approaches.

Show MeSH
Related in: MedlinePlus