Phosphorylated Akt1 expression is associated with poor prognosis in cutaneous, oral and sinonasal melanomas

// Ciro Soares 1 , Thayna Melo de Lima Morais 1 , Roman Carlos 2 , Fernanda Viviane Mariano 1, 3 , Albina Altemani 1, 3 , Maria Goretti Freire de Carvalho 4 , Marcelo Brum Correa 5 , Rodrigo Ribas Dias dos Reis 6 , Luciana Schultz Amorim 7 , Oslei Paes de Almeida 1 and Jacks Jorge 1 1 Department of Oral Diagnosis, Area of Pathology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil 2 Pathology Division, Centro Clinico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala 3 Department of Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil 4 Private Pathology Service, Natal, Rio Grande do Norte, Brazil 5 Head and Neck Surgery Department - Oncology Center (CEON), Fornecedores de Cana Hospital, Piracicaba, Sao Paulo, Brazil 6 Oncology Surgery Department - Cancer Center (CECAN), Santa Casa Hospital, Piracicaba, Sao Paulo, Brazil 7 Institute of Pathological Anatomy, Piracicaba, Sao Paulo, Brazil Correspondence to: Ciro Soares, email: ciro.dss@gmail.com Keywords: cutaneous melanomas; mucosal melanomas; p-Akt1; immunohistochemistry; prognosis Received: August 08, 2018      Accepted: November 26, 2018      Published: December 18, 2018 ABSTRACT Melanomas are highly aggressive tumours derived from melanocytes, which occur most commonly in the skin. Occasionally, these tumours may appear in oral and sinonasal mucous membranes. In this study, we performed a comparative analysis of the Phosphorylated Akt1 (p-Akt1) expression in 144 patients affected by cutaneous (CM), 34 oral cavity (OM), and 31 sinonasal melanomas (SNM). Similar to the metastatic cutaneous melanomas, p-Akt1 was overexpressed in 17/34 of the oral cavity and 20/31 of the sinonasal melanomas. In addition, the p-Akt1-nuclear expression was associated with poorer cancer-specific survival in cutaneous ( P < .0001), oral ( P < .0001), and sinonasal ( P = .001) melanomas. Multivariate analysis showed p-Akt1 to be an independent prognostic marker in oral ( P = .041) and sinonasal ( P < .0001) melanomas patients. In conclusion, p-Akt1 overexpression is an independent prognostic marker in mucosal melanomas and is significantly up-regulated in sinonasal melanomas. As both mucosal and metastatic cutaneous melanomas showed high frequency of p-Akt1 expression, these findings suggest that mucosal melanomas have a biological behaviour, similar to the aggressive cutaneous melanomas.