Pathologist, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
Pathologist, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; and.
Am J Dermatopathol. 2023 Nov 1;45(11):733-747. doi: 10.1097/DAD.0000000000002440.
Preferentially expressed antigen in melanoma (PRAME) is a tumor-associated antigen first identified in a melanoma patient and found to be expressed in most melanomas as well as in variable levels in other malignant neoplasms of epithelial, mesenchymal, or hematolymphoid lineage. Detection of PRAME expression in formalin-fixed paraffin-embedded tissue is possible by immunohistochemistry (IHC) with commercially available monoclonal antibodies. In situ and invasive melanoma frequently show a diffuse pattern of nuclear PRAME immunoreactivity which contrasts with the infrequent and typically nondiffuse staining seen in nevi. In many challenging melanocytic tumors, results of PRAME IHC and other ancillary tests correlate well, but not always: The tests are not interchangeable. Most metastatic melanomas are positive for PRAME, whereas nodal nevi are not. Numerous studies on PRAME IHC have become available in the past few years with results supporting the value of PRAME IHC as an ancillary tool in the evaluation of melanocytic lesions and providing insights into limitations in sensitivity and specificity as well as possible pitfalls that need to be kept in mind by practicing pathologists.
黑色素瘤中优先表达的抗原（PRAME）是一种肿瘤相关抗原，最初在一名黑色素瘤患者中被发现，发现在大多数黑色素瘤中均有表达，并且在其他上皮、间充质或造血淋巴谱系的恶性肿瘤中也以不同水平表达。通过免疫组织化学（IHC）用商业上可获得的单克隆抗体，可以检测福尔马林固定石蜡包埋组织中 PRAME 的表达。原位和侵袭性黑色素瘤通常显示弥漫性核 PRAME 免疫反应性，与痣中罕见且通常非弥漫性染色形成对比。在许多具有挑战性的黑色素瘤中，PRAME IHC 和其他辅助检测的结果相关性良好，但并非总是如此：这些检测不可互换。大多数转移性黑色素瘤对 PRAME 呈阳性，而结内痣则不是。过去几年，关于 PRAME IHC 的研究已经很多，结果支持 PRAME IHC 作为评估黑色素细胞病变的辅助工具的价值，并提供了对敏感性和特异性的局限性以及需要由实践病理学家注意的可能陷阱的深入了解。
