ArticleFrontiers in oncology2026
Prognostic value of BAP1 expression in uveal melanoma: a comparative study with histopathological factors in a large Spanish cohort.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To evaluate the prognostic significance of BRCA1-associated protein 1 (BAP1) nuclear expression in enucleated eyes with uveal melanoma (UM), and to compare its predictive value with classical clinicopathological factors in a large Spanish cohort. Design: Prospective, single-center, observational-cohort study. Subjects: A total of 150 consecutive patients diagnosed with posterior uveal melanoma and treated with primary enucleation at a national reference center between 2006 and 2024. Methods: Immunohistochemical analysis of BAP1 expression was performed on formalin-fixed, paraffin-embedded tumor sections. Nuclear staining was classified as low grade (<33% positive tumor nuclei) or high grade (≥33%). Clinicopathological features and survival outcomes were assessed, and multivariate Cox regression was used to identify independent prognostic factors for melanoma-specific survival. Main Outcome Measures: Melanoma-specific survival and its association with BAP1 nuclear expression and classical prognostic variables. Results: Low grade nuclear BAP1 expression was detected in 50% of tumors and was significantly associated with worse melanoma-specific survival (hazard ratio [HR] = 2.72; 95% confidence interval [CI]: 1.04-7.11; p = 0.041). Additional independent predictors of poor prognosis included vortex vein invasion (HR = 4.55; p = 0.028), extrascleral extension (HR = 4.73; p = 0.004), and epithelioid cell type (HR = 4.12; p = 0.019). No significant association was observed between BAP1 expression and sex, mitotic index, or Ki-67 proliferation rate. Conclusions: Low grade nuclear BAP1 immunostaining is a strong, independent predictor of poor prognosis in uveal melanoma, comparable to established histopathological features. Immunohistochemical assessment of BAP1 is a cost-effective tool for risk stratification in routine clinical practice.
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