| Abstract [eng] |
The aim of the study was to explore the prognostic and predictive significance of proliferative index Ki-67 and changes of imunological parameters in non-metastatic melanoma patients MATERIALS AND METHODS: To explore the prognostic and predictive significance of the proliferative index Ki-67, a retrospective analysis was performed with 80 patients, in whom primary non-metastatic melanoma with tumour thickness of ≥ 1,5 mm was diagnosed. A prospective study was performed to explore the immunological parameters in 27 patients who had been diagnosed with non-metastatic melanoma (pTis-pT4N0M0). The immunologic parameter values of patients were compared with those of the control group (39 subjects). RESULTS: Proliferative index Ki-67 in primary tumours had no significant prognostic value in melanoma patients non-treated with IFN-α, tumour thickness≥ 1.5 mm. However, survival of IFN-α treated non-metastatic melanoma patients with Ki-67 expressed in <16% cells was longer than that of the patients with Ki-67 expressed in ≥ 16% cells (p=0,016). The investigation of immunological parameters showed that the peripheral blood of melanoma patients contained a smaller amount of monocytes (p=0.0002) as well as cytotoxic T lymphocytes CD8highCD57- (p=0,009) compared to healthy controls (p=0.009). Patients had significantly higher counts of CD4+ (p=0.02) and CD8low (p=0.04) lymphocytes compared to healthy controls. CONCLUSIONS: Ki-67 proliferative index has no prognostic significance and has a predictive value in IFN-α-treated non-metastatic melanoma patients with tumour thickness ≥1.5 mm. Significant changes of peripheral blood immunocompetent cells are observed in patients with non-metastatic melanoma compared to healthy controls. |
