Telomerase reverse transcriptase promoter mutations and solar elastosis in cutaneous melanoma

Area of Science:

• Dermatology
• Oncology
• Molecular Biology

Background:

• Solar elastosis, a marker of chronic sun damage, and telomerase reverse transcriptase promoter mutations (TERTp) are potential prognostic factors in melanoma.
• The relationship between solar elastosis and TERTp in melanoma pathogenesis remains unclear.

Purpose of the Study:

• To assess the prognostic value of solar elastosis grading and TERTp in melanoma.
• To investigate the association between solar elastosis and TERTp.
• To evaluate the clinical and pathological correlations of these factors.

Main Methods:

• Histopathological evaluation of solar elastosis in 486 melanoma samples using hematoxylin and eosin staining.
• Detection of TERTp in 189 melanoma samples via pyrosequencing.
• Statistical analysis to determine associations and prognostic significance.

Main Results:

• No significant association was found between solar elastosis and TERTp (P=0.3).
• Severe elastosis correlated with older age, ulceration, and head/neck location, but predicted worse relapse-free survival independent of age.
• TERTp did not predict adverse outcomes but independently predicted melanoma-specific death at a specific cutoff, correlating with Breslow thickness, ulceration, and BRAF V600E status.

Conclusions:

• TERTp and severe solar elastosis are not directly related and may arise from different sun exposure patterns.
• Neither TERTp nor severe elastosis independently predicted adverse outcomes in the overall melanoma cohort.
• Absence of elastosis in younger patients may indicate melanomas arising from nevi, often associated with BRAF mutations.