Chromosomal abnormalities, p53 and Bcl-2 expression and clinical outcome in choroidal melanoma.
To determine whether alterations of p53, Bcl-2 and chromosomes were present in choroidal melanoma and to further characterize the prognosis of these changes. The expression of p53 and Bcl-2 protein was assessed by immunohistochemistry from paraffin blocks. Tumours were analysed by comparative genomic hybridization (CGH) to identify chromosomal aberrations. Fifteen tumours were studied, and the survival results were compared by Spearman correlation analysis with a mean follow-up of 36.5+/-8 months. The majority of tumours were mixed (eight cases), and the others were spindle cell (four cases) and epithelioid cell (three cases) types. Four patients have already died due to metastatic disease. p53 was expressed at a low percentage in only two tumours. There were no differences in Bcl-2 expression in our cases. Bcl-2 was expressed by the majority of cells in all cases. Chromosomal copy number aberrations were detected in 10 of the 15 patients by CGH analyses. A gain at chromosome 8 and a loss at chromosome 3 were the most frequently seen abnormalities. The other aberrations observed were losses at 6q, 7q14 and 17p13-15, and gains at 6p and 18q. Two of the three cases with a loss at 17p13 showed a low percentage expression of p53. No relationship was determined between the chromosomal abnormalities, cell type, expression of p53 and survey. The presence of a chromosome 6q deletion in two of the four patients who died of metastatic disease may indicate that chromosome 6q deletion may be correlated with a poor prognosis. Our results suggest that choroidal melanomas show high levels of chromosomal alterations. Further studies are necessary to determine the correlation between chromosomal abnormalities and prognosis.