Abstract
Uveal melanoma, in spite of its rarity, represents the most common primitive intraocular malignant neoplasm of the adults; it affects choroid, ciliary bodied and iris and remains clinically silent for a long time, being accidentally discovered by routine ophthalmic exams. Prognosis of uveal melanoma is poor and frequently characterized by liver metastases, within 10–15 years from diagnosis. Autophagy is a multi-step catabolic process by which cells remove damaged organelles and proteins and recycle nutrients. It has been hypothesized that in early stages of tumorigenesis autophagy has a tumor suppressor role while, in more advanced stages, it may represent a survival mechanism of neoplastic cells in response to stress. Several proteins related to autophagy cascade have been investigated in numerous subtypes of human cancer, with overall controversal results. In this paper we studied the immunohistochemical expression of 3 autophagy related proteins (Beclin-1, p62 and ATG7) in a cohort of 85 primary uveal melanoma treated by primary enucleation (39 with metastasis and 46 non metastatic) and correlated their expression with clinico-pathological parameters and blood vascular microvessel density, in order to investigate the potential prognostic role of autophagy in this rare neoplasm. We found that high immunohistochemical levels of Beclin-1 correlated with a lower risk of metastasis and higher disease-free survival times, indicating a positive prognostic role for Beclin-1 in uveal melanoma. No statistically significative differences regarding the expression of ATG7 and p62 between metastatic and non metastatic patients was detected.
Highlights
Uveal melanoma (UM) is traditionally considered a rare tumor, it is the most frequent primitive intraocular malignancy of the adults and the second most frequent melanoma not associated with epithelial structures [1,2,3]
Recent reports evidenced that the use of sun-tanning devices is a wellrecognized risk factor for uveal melanoma, as opposed to sunlight exposure, hypothesizing that this phenomenon could be correlated to the inability of artificial tanning to increase systemic level of vitamin D3 [7]
Several clinical and histopathological factors have been traditionally included among the ones negatively affecting the prognosis of uveal melanoma (UM): advanced age and stage at diagnosis, male gender, tumor thickness and largest diameter, ocular/cutaneous melanocytosis, localization to ciliary bodies, extrascleral invasion
Summary
Uveal melanoma (UM) is traditionally considered a rare tumor, it is the most frequent primitive intraocular malignancy of the adults and the second most frequent melanoma not associated with epithelial structures [1,2,3]. The ultimate role of UV-B and UV-A exposure as a risk factor for uveal melanoma is still to be fully clarified. Recent reports evidenced that the use of sun-tanning devices is a wellrecognized risk factor for uveal melanoma, as opposed to sunlight exposure, hypothesizing that this phenomenon could be correlated to the inability of artificial tanning to increase systemic level of vitamin D3 [7]. Syndromic/congenital diseases such as cutaneous dysplastic nevus syndrome, oculo-dermal melanocytosis (Ota nevus) and type 1 neurofibromatosis, have traditionally been included among risk factors associated with the onset of UM [8]. Several steps have been made in the knowledge and treatment of this neoplasm, the prognosis of UM remains poor with about half of patient developing distant metastases, especially in the liver, within 1015 years from primary enucleation [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
