Polyomavirus-Negative Merkel Cell Carcinoma: A More Aggressive Subtype Based on Analysis of 282 Cases Using Multimodal Tumor Virus Detection Ata S. Moshiri,

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Polyomavirus-Negative Merkel Cell Carcinoma: A More Aggressive Subtype Based on Analysis of 282 Cases Using Multimodal Tumor Virus Detection Ata S. Moshiri, Ryan Doumani, Lola Yelistratova, Astrid Blom, Kristina Lachance, Michi M. Shinohara, Martha Delaney, Oliver Chang, Susan McArdle, Hannah Thomas, Maryam M. Asgari, Meei-Li Huang, Stephen M. Schwartz, Paul Nghiem Journal of Investigative Dermatology Volume 137, Issue 4, Pages 819-827 (April 2017) DOI: 10.1016/j.jid.2016.10.028 Copyright © 2016 The Authors Terms and Conditions

Figure 1 Detection of MCPyV DNA and oncoprotein in MCC tumors. Schematic diagram of the MCPyV small and large T antigens. Numbers correspond to the nucleotide position in the MCPyV genome. The LT4 primer set targets a 60-base pair segment of the persistently expressed portion of the truncated large T antigen. The asterisk indicates the TaqMan probe location (see Materials and Methods for details). The colored brackets in the lower portion of the figure show amino acid positions of antigens used to generate the large T antibodies: CM2B4 (blue) and Ab3 (red). a. a., amino acid; MCC, Merkel cell carcinoma; MCPyV, Merkel cell polyomavirus. Journal of Investigative Dermatology 2017 137, 819-827DOI: (10.1016/j.jid.2016.10.028) Copyright © 2016 The Authors Terms and Conditions

Figure 2 Flowchart of survival analysis inclusion criteria. All patients with clinical follow-up data were included in survival analysis. For progression-free survival, patients who presented with metastatic disease were excluded from analysis. IHC, immunohistochemistry; MCC, Merkel cell carcinoma; qPCR, quantitative PCR. Journal of Investigative Dermatology 2017 137, 819-827DOI: (10.1016/j.jid.2016.10.028) Copyright © 2016 The Authors Terms and Conditions

Figure 3 Kaplan-Meier curves of survival among MCC patients whose tumors were MCPyV-positive or -negative. (a) Patients with virus-negative tumors had significantly decreased progression-free survival (P = 0.0052). (b) Patients with virus-negative tumors had significantly decreased MCC-specific survival (P = 0.015). (c) Patients with virus-negative tumors had a nonsignificant trend for poorer overall survival (P = 0.14). MCC, Merkel cell carcinoma. Journal of Investigative Dermatology 2017 137, 819-827DOI: (10.1016/j.jid.2016.10.028) Copyright © 2016 The Authors Terms and Conditions