Investigation of the role and importance of Bap1, Ezh2 and 5hmc molecules in melanoma diagnosis and progression

Background-Aim: Melanoma is the most fatal skin cancer with increasing incidence. In early- stage tumors, surgery is usually therapeutic whereas survival is dramatically decreased in metastatic tumors. In recent years, it is well established that melanoma has a heterogenous genomic landscape. Additionally, diagnostic and therapeutic role of the epigenetic alterations have become important in various cancer types as well as in melanoma. Aim of our study is to re-evaluate primary cutaneous melanoma cases clinicopathologically, and to analysis the expressions of BAP1, EZH2 and 5hmC molecules immunohistochemically and to search the the prognostic and diagnostic roles, statistically. Material-Method: One hundred fourteen melanoma and 49 intradermal nevus cases were selected from the archive of Cukurova University Medical Faculty Pathology Department. Hematoxyline and Eosine slides were re-evaluated. Immunohistochemically, BAP1, 5hmC and EZH2 was performed to all cases, the results were analyzed statistically. Results: %59,7 of melanoma cases was male, mean age was 60,3 years. %50,9 cases were deceased, median death period was 55 months. BAP1 loss was statistically significantly related to longer survival time and overall survival, lesser lymph node metastasis and ulceration. 5hmC loss was statistically related to only transit nodule presence. Mean EZH2 score was statistically significantly related to ulceration, Breslow, lymph node metastasis, transit nodule, distant metastasis, and deceased case ratio. Discussion:Loss of BAP1 and 5hmC and overexpression of EZH2 plays an important role in melanoma. Our results reveal that loss of BAP1 is associated with better survival and longer lifetime. 5hmC plays an important role in melanoma progression as well as overexpression of EZH2. EZH2 overexpression is a poor prognostic factor and increases death risk. Besides the pathogenetic and prognostic importance of these markers, they seem to be promising in treatment of melanoma for both targeted therapy and adjunct to combinated therapy.