Abstract:

Zeng Ying, Kang Xiaojing, Zhang Xiangyue, Jin Ying, Chai Li, Zeng Mingfeng, Wang Ying, Wang Weijia Department of Dermatology and Venereology, People′s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China （the current affiliation of the first author was Graduate School, College of Medicine, Shihezi University, Shihezi 832002, Xinjiang, China） Corresponding author: Kang Xiaojing, Email: drkangxj666@163.com 【Abstract】 Objective To detect NRAS gene mutations in patients with acral melanoma, and to analyze their relationship with the prognosis of acral melanoma. Methods Clinical and pathological data were collected from 55 patients with pathologically diagnosed acral melanoma. DNA was extracted from paraffin?embedded specimens from lesions of the 55 patients and 15 patients with nevus. PCR and direct DNA sequencing were performed to detect NRAS gene mutations. Univariate and multivariate analyses were performed using the Cox′s proportional hazards regression model. Results Of the 55 patients, 6 （10.9%） carried the Q61R mutation in codon 61 of the NRAS gene. No mutations were found in exon 1 or 2 of the NRAS gene in any of these paraffin?embedded specimens, and none of the pigmented nevus specimens harbored NRAS gene mutations. Of the 6 patients carrying NRAS gene mutations, 4 had lymph node metastasis. Multivariate Cox regression analysis showed that independent factors of poor prognosis included advanced clinical stage （RR = 2.54, 95% CI: 1.062 - 6.066, P < 0.05）, not receiving surgical resection （RR = 2.98, 95% CI: 1.316 - 3.525, P < 0.05）, and carrying NRAS gene mutations （RR = 2.73, 95% CI: 0.932 - 3.257, P < 0.05）. Conclusions NRAS gene mutations may be associated with lymph node metastasis in patients with acral melanoma. The prognosis of acral melanoma may be associated with clinical staging, treatment strategies and NRAS gene mutations. Additionally, NRAS gene mutations may serve as a new index for predicting prognosis of acral melanoma.