PRAME/MELAN-A双重免疫染色作为结膜黑素细胞性病变的诊断工具：一项南美经验。
PRAME/MELAN-A double immunostaining as a diagnostic tool for conjunctival melanocytic lesions: A South American experience.
作者信息
Carvajal Pedro, Zoroquiain Pablo
机构信息
Pathology Department, School of Medicine, Pontificia Universidad Católica de Chile, Chile.
Pathology Department, School of Medicine, Pontificia Universidad Católica de Chile, Chile.
出版信息
Pathol Res Pract. 2023 Oct;250:154776. doi: 10.1016/j.prp.2023.154776. Epub 2023 Aug 23.
INTRODUCTION
PRAME (PReferentially expressed Antigen in Melanoma) is an antigen that is predominantly expressed in human melanomas. In cutaneous melanocytic lesions, PRAME expression is associated with malignancy. The objective of this study was to evaluate the co-expression of PRAME and Melan A to evaluate their diagnostic value in different conjunctival melanocytic lesions (CML).
METHODS
37 CML (23 nevi, 9 primary acquired melanosis (PAM), and 5 conjunctival melanomas) were evaluated by immunohistochemistry for PRAME and Melan-A. The percentage of melanocytic cells co-expressing PRAME and Melan-A was qualitatively evaluated as follows: negative, 0%; 1 + , 1-25%; 2 + , 26-50%; 3 + , 51-75% and 4 + , ≥ 76%.
RESULTS
Of the invasive melanoma cases, 80% showed a 4 + pattern of marking, whereas 20% showed a 3 + pattern. 11% of the PAMs showed a 4 + pattern and 88.9% showed a 1 + pattern. All the nevi showed a 1 + pattern. The sensitivity and specificity of PRAME 4 + for differentiating high-grade CML from the benign and low-grade grouped CML are 93% and 100%, respectively.
CONCLUSION
PRAME/MELAN-A double immunostain is particularly useful to differentiate benign from malignant conjunctival melanocytic lesions.
引言
PRAME（黑色素瘤中优先表达的抗原）是一种主要在人类黑色素瘤中表达的抗原。在皮肤黑素细胞病变中，PRAME的表达与恶性肿瘤相关。本研究的目的是评估PRAME和Melan A的共表达情况，以评价它们在不同结膜黑素细胞病变（CML）中的诊断价值。
方法
采用免疫组织化学法对37例CML（23例痣、9例原发性获得性黑素沉着症（PAM）和5例结膜黑色素瘤）进行PRAME和Melan-A检测。共表达PRAME和Melan-A的黑素细胞百分比按以下标准进行定性评估：阴性，0%；1+，1%-25%；2+，26%-50%；3+，51%-75%；4+，≥76%。
结果
在侵袭性黑色素瘤病例中，80%表现为4+标记模式，而20%表现为3+模式。11%的PAM表现为4+模式，88.9%表现为1+模式。所有痣均表现为1+模式。PRAME 4+用于区分高级别CML与良性和低级别CML组合的敏感性和特异性分别为93%和100%。
结论
PRAME/MELAN-A双重免疫染色对鉴别结膜黑素细胞良性和恶性病变特别有用。
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