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G1 cell cycle regulators in congenital melanocytic nevi. Comparison with acquired nevi and melanomas.

BACKGROUND: Congenital nevi are one of the known risk factors for the development of melanoma. However, the magnitude of the risk for both large and small congenital nevi is controversial.

METHODS: In order to elucidate the behavior of congenital nevocytes and to define any possible similarities or differences with common nevi and melanomas, we investigated the expression of Ki-67, Rb, p16, cyclin D1, p53 and p21/Waf-1 in 41 congenital nevi, 16 melanomas and 20 acquired common nevi by immunohistochemistry.

RESULTS: Congenital nevi highly expressed p16 (81.82 +/- 9.98) but showed limited, if any, reactivity for Ki-67 (1.34% +/- 0.89), Rb (0.76% +/- 0.94), cyclin D1 (0.21% +/- 0.29), p53 (0.54% +/- 0.93) and p21 (0.0609% +/- 0.32). No statistically significant difference was found between giant and nongiant congenital nevi and between congenital and common nevi for any of the markers. The expression of p16 was significantly higher in congenital nevi than in melanomas (p < 0.0001). On the contrary, the expression of Ki-67, p53, p21, Rb and cyclin D1 was significantly higher in melanomas (p < 0.0001).

CONCLUSION: Our data regarding the immunohistochemical expression of Rb, p16, p53, cyclin D1 and Ki-67 in congenital nevi indicate that either the alteration of their expression is not an initiating event in melanoma formation or, alternatively, congenital melanocytic nevi may not be the first step in malignant transformation.

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