免疫组织化学检测 PRAME 在甲下和非甲下肢黑素细胞病变中的诊断价值。

Diagnostic utility of PRAME expression by immunohistochemistry in subungual and non-subungual acral melanocytic lesions.

机构信息

Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

出版信息

J Cutan Pathol. 2022 Oct;49(10):859-867. doi: 10.1111/cup.14290. Epub 2022 Jul 25.

DOI:10.1111/cup.14290

PMID:35794643

Abstract

BACKGROUND

The immunohistochemical (IHC) marker PReferentially expressed Antigen in MElanoma (PRAME) has shown promise in the diagnosis of melanocytic lesions. A few studies have investigated PRAME IHC expression in acral melanomas, but PRAME expression in subungual melanomas is largely unknown. We evaluated the utility of PRAME IHC expression in distinguishing subungual melanomas (SUM) and non-subungual acral melanomas (AM) from acral nevi (AN).

METHODS

Twenty-two SUM, 20 AM, and 14 AN were identified. IHC studies were performed using an anti-PRAME antibody. The percentage of lesional cells with PRAME expression was recorded and categorized as follows: 0%, 0; 1%-25%, 1+; 26%-50%, 2+; 51%-75%, 3+; and >75%, 4+. Patient demographics and other relevant clinicopathologic parameters were recorded.

RESULTS

Diffuse (4+) PRAME IHC expression was identified in 55% (12/22) SUM and 70% (14/20) AM, respectively. Any PRAME expression (1+ to 4+) was identified in 73% (16/22) SUMs and 95% (19/20) AM, respectively. One of 14 (7%) AN exhibited PRAME expression; interestingly, the pattern of expression was diffuse.

CONCLUSIONS

In our study, PRAME IHC expression was useful in identifying AM, including SUM. However, there are exceptions of PRAME-negative melanomas and PRAME-positive nevi.

摘要

背景

免疫组织化学（IHC）标志物黑色素瘤中优先表达抗原（PRAME）在诊断黑色素细胞病变方面显示出了潜力。有几项研究调查了肢端黑色素瘤中 PRAME 的 IHC 表达，但甲下黑色素瘤中 PRAME 的表达在很大程度上尚不清楚。我们评估了 PRAME IHC 表达在区分甲下黑色素瘤（SUM）和非甲下肢端黑色素瘤（AM）与肢端痣（AN）中的作用。

方法

确定了 22 例 SUM、20 例 AM 和 14 例 AN。使用抗 PRAME 抗体进行 IHC 研究。记录了有 PRAME 表达的病变细胞百分比，并分为以下几类：0%，0；1%-25%，1+；26%-50%，2+；51%-75%，3+；>75%，4+。记录了患者的人口统计学和其他相关临床病理参数。

结果

分别有 55%（12/22）的 SUM 和 70%（14/20）的 AM 显示弥漫性（4+）PRAME IHC 表达。分别有 73%（16/22）的 SUM 和 95%（19/20）的 AM 显示任何 PRAME 表达（1+至 4+）。14 例 AN 中有 1 例（7%）显示 PRAME 表达；有趣的是，其表达模式是弥漫性的。