Epithelial Mesenchymal Transition Markers as Relevant Parameters for Risk Stratification of Poor Clinical Outcomes in Patients with Early-Stage Cutaneous Melanoma

Objective : To evaluate the prognostic significance of Epithelial Mesenchymal Transition (EMT) transition markers and their association with clinicopathological characteristics of cutaneous melanoma. Materials and Methods : Histopathological and immunohistochemical examination of primary tumor tissue samples was performed in 101 patients with cutaneous melanoma of stage pT1a–1b. The study evaluated the expression of E-cadherin, TWIST, vimentin, Ki-67, Melan-A, and S100 markers. Results : A significant correlation was identified between the expression of TWIST, vimentin, and E-cadherin and the depth of tumor invasion, primary tumor ulceration, and risk of progression. Disease progression was observed in patients with TWIST and vimentin expression levels > 20%, and E-cadherin expression < 80%. Ulceration of the skin was significantly associated with enhanced EMT features and a greater risk of metastatic dissemination. Conclusion : The analysis of the obtained results confirms the clinical significance of epithelial–mesenchymal transition markers as independent predictors of disease outcome, also emphasizes the key role of ulceration as an important morphological risk factor for disease progression. The proposed prognostic model, based on the assessment of relative expression levels of TWIST, vimentin, and E-cadherin, provides reliable classification of patients according to their risk of complication development.