Cytoplasmic accumulation of peanut agglutinin-binding glycoconjugates in the cells of primary melanoma correlates with clinical outcome.

In an experimental model, human melanoma cell lines enriched for cells that express the glycoconjugate B-D galactose N-acetyl-D-galactosamine, which reacts with the peanut agglutinin lectin (PNA), are associated with an increase in the frequency of metastases. We previously showed that this glycoconjugate is expressed on the cells of some primary melanomas in humans and that such cells are found selectively in melanomas with a high risk for developing metastases and causing death. Using fixed archival tissues from 99 primary melanomas and lectin histochemistry, we found 65 tumors that contained melanoma cells that were PNA-positive. PNA-reactive cells were not identified in normal melanocytes or in the nevocytes of 24 nevi. PNA-reactive material accumulates adjacent to the nucleus in the area of the Golgi apparatus, initially as a tiny dot, but later in quantities sufficient to displace and indent the nucleus, producing a signet ring cell-like appearance. Tumor cells containing PNA-reactive material were associated with more evolved, deeper, and thicker tumors. Two melanomas up to Clark level II were PNA positive (20%), compared with 60% of level III, 76% of level IV, and 100% of level V. Five of 13 tumors less than 0.76 mm thick (39%) were positive, compared with 50% of tumors 0.76 to 1.49 mm thick, 64% of tumors 1.5 to 2.99 mm thick, and 85% of tumors 3 mm thick or thicker. PNA-reactivity was negatively correlated with disease-free survival (PNA-negative, 49.2+/-23 months; PNA-positive grade 1, 41.6+/-26 months and PNA-positive grade 2, 24.4+/-23 months), survival rate 5 years after initial treatment (PNA-negative, 84.8%; PNA-positive grade 1, 63.8%; and PNA-positive grade 2, 31.3%) and disease-free survival at 5 years after initial treatment (PNA-negative, 69.7%; PNA-positive grade 1, 53.2%; and PNA-positive grade 2, 25%).