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Correlation of serum tryptase levels with total number of nevi, Breslow thickness, ulceration, and mitotic index in melanoma patients

evaluation of a promising prognostic marker

Crincoli, Emanuelea; Moliterni, Elisaa; Catania, Fiammettab; Didona, Dariod; Calvieri, Stefanoa; Paolino, Giovannia,c

doi: 10.1097/CMR.0000000000000561
Original Articles: Clinical Research

Current evidences suggest that mast cells contribute to the proliferation and differentiation of skin melanocytes. According to these findings, we carried out an observational cross-sectional study to investigate the correlation between the total number of nevi (TN), Breslow thickness (BT), and serum tryptase (ST) levels in a cohort of 35 melanoma (MM) patients. A Mann–Whitney test was performed to compare ST values within each variable. Subsequently, the independent predictive factors were assessed by multiple logistic regression. Pearson’s χ2-test was chosen to detect statistically significant findings on the TN and the histopatological variables (Breslow, ulceration, and mitotic index). The TN was assessed using a dichotomous scale (≤ 10 or > 10). Patients with TN of 10 or less (3.48 vs. 6.05 ng/ml; P = 0.045), patients with a Breslow thickness of at least 1.01 mm (2.99 vs. 5.67 ng/ml; P = 0.1), and ulcerated MM (2.37 vs. 6.05 ng/ml; P < 0.001) showed lower median ST levels. Similarly, MM with mitotic index of at least 1/mm2 had median ST levels lower than MM with mitotic index less than 1/mm2 (P = 0.005). Multiple logistic regression confirmed the statistical significance for the variables ulceration, TN, and mitotic index. Pearson’s χ2-test showed a statistically significantly (P = 0.003) increased prevalence of MMs with a BT of at least 1.01 mm in patients with a TN of 10 or less. Patients with a TN of 10 or less also showed a higher prevalence of ulceration and mitotic index of at least 1/mm2 in comparison with the rest of the cohort. Our study highlights lower median ST levels in patients whose MM thickness is at least 1.01 mm; this may encourage new studies on the role of ST in MM also according to the number of nevi.

aDermatologic Clinic, Department of Internal Medicine and Medical Specialties, La Sapienza University of Rome

bFaculty of Medicine, Catholic University of the Sacred Heart, Rome

cDermatology Unit, IRCCS San Raffaele University Policlinic, Milan, Italy

dKlinikfür Dermatologie und Allergologie, UniversitätsklinikumMarburg, Marburg, Germany

Received 25 February 2018 Accepted 6 November 2018

Correspondence to Elisa Moliterni, MD, Dermatologic Clinic, Dipartimento di Medicina Interna e Specialità Mediche, La Sapienza University of Rome, viale del Policlinico 155, Rome 00161, Italy Tel: + 39 328 578 3685; fax: + 39 064 997 9436/+39 06 444 1255; e-mail:

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