Perez-Perez Manuel, García de Sola-Llamas Carmen, Mariscal Gonzalo, Macías-García Laura
Anatomía Patológica, Hospital Universitario Quirónsalud Sevilla, Seville, Spain
Centro de Anatomía Patológica y Citopatología Doctor Galera, Seville, Spain.
J Clin Pathol. 2025 Jul 18;78(8):519-526. doi: 10.1136/jcp-2024-210032.
Overexpression of Preferentially Expressed Melanoma Antigen (PRAME) is associated with melanoma progression. In the case of uveal melanoma (UM), PRAME expression was identified as conferring a metastatic risk.
This study aimed to review the available evidence regarding the prognostic value of PRAME expression in UM.
This study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included cohort studies and randomised clinical trials. The methodological quality of the studies was assessed by the Methodological Index for Non-Randomised Studies (MINORS). The meta-analysis was performed using Review Manager V.5.4. Heterogeneity was checked with the I2 test. If there was no heterogeneity, a fixed-effects model was adopted.
Nine studies were included. The PRAME+ group showed significant differences in the development of metastases OR (M-H, Fixed, 95% CI): 3.46 (2.84, 4.22). The PRAME+ group had a significantly shorter time to metastasis MD (IV, Random, 95% CI): -28.31 (-55.41, -1.22) and a significantly lower percentage metastasis-free survival at 5-year follow-up MD (IV, Fixed, 95% CI): -21.67 (-25.74,-17.61). PRAME expression was an independent marker for the development of metastatic disease at any follow-up HR (IV, Fixed, 95% CI): 2.00 (1.60, 2.49). In addition, PRAME+tumours were significantly larger than PRAME-tumours MD (IV, Random, 95% CI): 0.22 (0.01, 0.42).
PRAME is a good prognostic marker in UM. We believe that further studies are needed to determine the most cost-effective method for reporting PRAME overexpression.
优先表达的黑色素瘤抗原（PRAME）的过表达与黑色素瘤进展相关。在葡萄膜黑色素瘤（UM）病例中，PRAME表达被确定为具有转移风险。
本研究旨在综述关于PRAME表达在UM中的预后价值的现有证据。
本研究遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。我们纳入了队列研究和随机临床试验。研究的方法学质量通过非随机研究的方法学指数（MINORS）进行评估。使用Review Manager V.5.4进行Meta分析。用I2检验检查异质性。如果没有异质性，则采用固定效应模型。
纳入9项研究。PRAME阳性组在转移发生方面显示出显著差异，比值比（M-H，固定效应，95%置信区间）：3.46（2.84，4.22）。PRAME阳性组发生转移的时间显著更短，平均差（IV，随机效应，95%置信区间）：-28.31（-55.41，-1.22），并且在5年随访时无转移生存率的百分比显著更低，平均差（IV，固定效应，95%置信区间）：-21.67（-25.74，-17.61）。在任何随访时，PRAME表达都是转移性疾病发生的独立标志物，风险比（IV，固定效应，95%置信区间）：2.00（1.60，2.49）。此外，PRAME阳性肿瘤显著大于PRAME阴性肿瘤，平均差（IV，随机效应，95%置信区间）：0.22（0.01，0.42）。
PRAME是UM中的一个良好预后标志物。我们认为需要进一步研究以确定报告PRAME过表达的最具成本效益的方法
