The Expression And Significance Of MEK,ERK,PPO And AKT Protein In Sinonasal Malignant Melanoma

ObjectiveTo investigate the clinical characteristics of sinonasal malignant melanoma.To explore the expression of MEK,ERK,AKT,PPO in sinonasal malignant melanoma histopathological specimens and its status in occurrence and progress of melanoma.In order to find a new therapeutic target of sinonasal malignant melanoma during its development,and provide important clinical basis of pathogenesis and early intervention for sinonasal malignant melanoma prognosis.Methods1.All the clinical data of sinonasal malignant melanoma patients which were treated with reasonable surgery are taken from the Department of Otolaryngology of the Affiliated Hospital of Qiingdao University Between January 2014 to January 2017.which were treated with reasonable surgery.2.To collect the pathological wax block according to the admission number,each wax block was marked with a number of pathological marks,and review all cases of HE staining pathological sections.Then we mark all the tissue wax blocks.The clinical and pathological data of each patient were recorded in detail,including age,gender,clinical symptoms and signs,tumor origin,lymph node metastasis,etc.All cases were staged according to the TNM pathological staging criteria for head and neck mucosal melanoma developed in the seventh edition of AJCC in 2010,and were followed up.3.All pathologic wax blocks were disrupted after the pathological numbers of the refractory group and the control group were recorded separately,then randomly select wax block to reordering.Dewaxing,sectioning and staining the pathological wax block,processed for histological studies.Research method:Using immunhistochemical method staining the pathological sections counting the number of MEK?ERK?AKT?PPO labeled positive in sinonasal malignant melanoma respectively.As well as searching fortherelationship between the expression of four markers and clinicopathologicalparameters(including gender,age and clinical stage).4.Statistical analyses were done with the SPSS version 22.0software.The Chi-square test was used to compare distributions among groups,A value of P < 0.05 was regarded as statistically significant.Results1.Among the 14 patients with sinonasal malignant melanoma,28.6%(4 cases)were men,71.4%(10 cases)were women,and the age range was 51-83 years.The average age was 64.93±9.33 years.The main symptoms of the patients wereepistaxis,bloody sputum and nasal obstruction.All cases were unilateral nasal cavity,and dark red,purple and black lesions were seen in the nasal cavity.A surgical procedure with curative intent was performed in 14 patients.The tumour was located in the Middle turbinate,inferior turbinate,nasal septum and nasal bottom moucosa.Treatment included surgery alone,surgery combined with radiotheray,surery combined with chemotherapy and Surgery combined with radiotherapy and chemotherapy.4 local recurrence after resection occurred,3 cases death.The main causes of death are distant metastasis and Intolerance and chemotherapy.2.The positive rates of MEK,ERK,AKT,PPO expression in sinonasal malignant melanoma were all greater than 70%.The positive expression rates of MEK,ERK,PPO and AKT were 13 cases,12 cases,11 cases and 13 cases respectively.The positive expression rates were 92.9%,85.7%,78.6% and 92.9%,respectively.There was no significant correlation between these four proteins and age,gender,and TNM staging(P>0.05).The expression of MEK and ERK,MEK and PPO in SNMM did not correlate with each other(P>0.05);The expression of ERK and PPO in SNMM express difference was statistically significant(P<0.05).Conclusion1.The incidence of sinonasal malignant melanoma was mainly elderly,and the clinical symptoms were unilateral epistaxis and nasal obstruction;Tumors originated from the middle turbinate,inferior turbinate,nasal septum and nasal bottom moucosa;Operation is the main method of treatment as the supplement.2.The expression rate of MEK,ERK,PPO and AKT in sinonasal malignant melanoma is relatively high,suggesting that:(1)ERK is one of the pathogenesis of sinonasal malignant melanoma;(2)The higer expression rate of ERK and its upstreamMEK may be related to the high expression of PPO.(3)The high expression of AKT is also one of important molecules in the carcinogenesis and development of sinonasal malignant melanoma.3.MEK,ERK,PPO and AKT can be used as a new target for the treatment of sinonasal malignant melanoma.