| Abstrak/Abstract |
Background: Melanoma is a lethal skin malignancy with a high risk of metastasis, which
prompts a need for research on treatment targets and prognostic factors. Recent studies
show that the presence of neuroblastoma RAS viral oncogene homolog (NRAS) mutation
can influence cell growth in melanomas. The NRAS mutation, which stimulates the mitogen-
activated protein kinase (MAPK) signaling pathway, is associated with a lower survival
rate. However, evidence from Indonesia population is still very rare. Further understanding
of the role of NRAS mutations in Indonesian melanoma cases will be crucial in developing
new management strategies for melanoma patients with NRAS mutations.
Aims: To explore the frequency of NRAS mutations and their clinicopathological associations
in patients with primary nodular cutaneous melanoma in Central Java and
Yogyakarta, Indonesia.
Methods and results: Fifty-one paraffin-embedded tissue samples were collected from
primary nodular skin melanoma cases between 2011 and 2019 from the two largest referral
hospitals in Yogyakarta and Central Java, Indonesia. The NRAS mutation status was evaluated
using qualitative real-time polymerase chain reaction (qRT-PCR). The association of
NRAS mutation was analyzed with the following: age, gender, location, lymph node metastasis,
ulceration, mitotic index, tumor-infiltrating lymphocytes (TILs), necrosis, tumor thickness,
lymphovascular invasion (LVI), and tumor size. NRAS mutations were detected in
10 (19.6%) samples and predominantly observed (60%) in exon 2 (G12). These mutations
were significantly correlated with lymph node metastases (p = .000); however, they were
not associated with other variables analyzed in this study.
Conclusions: The prevalence of NRAS mutations in primary nodular cutaneous melanoma
cases from Indonesia is consistent with previous studies and is significantly
associated with increased lymph node metastases. However, the predominant mutation
detected in exon 2 (G12) is different from previous studies conducted in other
countries. This suggests that melanoma cases in Javanese people have different characteristics
from other ethnicities. |
