Abstract
BackgroundThe aim of this study was to determine the prevalence of MCPyV in Merkel cell carcinoma (MCC) primaries versus lymph node metastasis and to evaluate possible prognostic factors.MethodsSamples of MCC primaries and lymph node metastases were stained immunohistochemically for the MCPyV large T-antigen and expression was compared to patients´ clinical outcome.Results41 MCC patients were included. 33 (61%) out of 54 specimens were MCPyV-positive in the immunohistochemistry. 15 (47%) out of 32 primary tumors were positive compared to 18 (82%) out of 22 lymph node metastases. Eleven patients with positive polyomavirus expression died from the carcinoma compared to 4 patients without virus expression. Cox regression analysis showed worse disease-free survival in patients with MCPyV compared to virus-negative lymph nodes (p = 0.002).ConclusionsTo our knowledge this is the first study to describe a negative prognostic effect of the MCPyV expression in lymph node metastasis in MCC patients.
Highlights
Merkel cell carcinoma (MCC) is the most aggressive skin cancer and found as neuroendocrine neoplasm predominantly in elderly white patients [1]
The aim of this study was to determine the prevalence of Merkelcell polyomavirus (MCPyV) in Merkel cell carcinoma (MCC) primaries versus lymph node metastasis and to evaluate possible prognostic factors
Samples of MCC primaries and lymph node metastases were stained immunohistochemically for the MCPyV large T-antigen and expression was compared to patientsclinical outcome
Summary
Merkel cell carcinoma (MCC) is the most aggressive skin cancer and found as neuroendocrine neoplasm predominantly in elderly white patients [1]. In 2008 the Merkelcell polyomavirus (MCPyV) has been found to be associated with the pathogenesis in MCC patients. The MCPyV large T-antigen (LTA) expression in MCC tumors varies between 40 to 100% in current studies and has been shown to be higher in skin areas less exposed to UV light. We conducted a retrospective chart review of MCC patients and compared MCPyV LTA expression in the tumor of the skin with regional lymph node metastases. The aim of this study was to determine the prevalence of MCPyV in Merkel cell carcinoma (MCC) primaries versus lymph node metastasis and to evaluate possible prognostic factors
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