Combined immunohistochemistry of PRAME and p16 in the differentiation of melanocytic neoplasms, with a detailed focus on acral lesions.

IF 2.4 3区医学 Q2 PATHOLOGY Diagnostic Pathology Pub Date : 2024-12-27 DOI:10.1186/s13000-024-01586-y

Jingwei Zheng, Jie Zang, Qiuju Miao, Xuebao Shao, Hao Song, Xiaopo Wang, Ying Zhang, Hao Chen

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Abstract

Background: Isolated immunohistochemical indicators are limited to diagnose melanocytic neoplasms. This retrospective study is to assess the diagnostic value of combined immunohistochemical analysis targeting preferentially expressed antigen in melanoma (PRAME) and p16 in melanocytic neoplasms, with a detailed focus on arcal lesions.

Methods: This was a single center cohort study from January 2022 to June 2023. A total of 165 identified cases were collected, including 112 melanomas (MMs) and 53 melanocytic nevi, which were composed of 122 acral samples and 43 non-acral samples. Immunohistochemistry(IHC) for both PRAME and p16 was performed in these cases, which was subsequently statistically analyzed to assess the diagnosis ability of PRAME and p16.

Results: In total samples, the sensitivity and specificity of PRAME(+) for MM are 82.1% and 94.3% (AUC = 0.882, 95%CI:0.827-0.938), while of p16(-) for MM are 31.25% and 94.3% (AUC = 0.628, 95%CI:0.542-0.714); PRAME(+)/p16(-) (meaning as PRAME(+) or p16(-)) displayed a sensitivity and specificity of 85.7% and 88.7% for MM (AUC = 0.872, 95%CI:0.810-0.934), while PRAME(+) &p16(-) (meaning as PRAME(+) and p16(-)) revealed a sensitivity and specificity of 27.7% and 100% in MM (AUC = 0.638, 95%CI:0.555-0.722). In acral samples, PRAME(+)/p16(-) exhibited a specificity of 94.7% and a sensitivity of 86.9% for MM (AUC = 0.908, 95%CI: 0.849-0.968), with sensitivities of 90.9% for invasive MM and 82.5% for preinvasive MM, respectively; The sensitivity and specificity of PRAME(+) &p16(-) for MM is 22.6% and 100% (AUC = 0.613, 95%CI: 0.513-0.714) respectively. In non-acral samples, the sensitivity and specificity of PRAME(+)/p16(-) for MM are 82.1% and 73.3% (AUC = 0.777, 95%CI: 0.622-0.933), while of PRAME(+) &p16(-) are 42.9% and 100% (AUC = 0.714, 95%CI:0.564-0.864).

Conclusion: Combined IHC of PRAME and p16 contributes to discriminating melanocytic neoplasms, especially for in situ acral MM.

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PRAME和p16联合免疫组化在黑色素细胞肿瘤分化中的作用，重点关注肢端病变。

背景：孤立的免疫组织化学指标在诊断黑色素细胞肿瘤方面是有限的。本回顾性研究旨在评估针对黑色素瘤中优先表达抗原（PRAME）和p16的联合免疫组织化学分析在黑色素细胞肿瘤中的诊断价值，并详细关注于arcal病变。方法：这是一项单中心队列研究，时间为2022年1月至2023年6月。共收集确诊病例165例，其中黑色素瘤112例，黑素细胞痣53例，其中肢端122例，非肢端43例。对这些病例进行PRAME和p16的免疫组化（IHC）检测，随后进行统计学分析，以评估PRAME和p16的诊断能力。结果：PRAME（+）对MM的敏感性和特异性分别为82.1%和94.3% (AUC = 0.882, 95%CI:0.827 ~ 0.938), p16（-）对MM的敏感性和特异性分别为31.25%和94.3% (AUC = 0.628, 95%CI:0.542 ~ 0.714)；PRAME(+)/p16(-)（意为PRAME（+）或p16(-)）对MM的敏感性和特异性分别为85.7%和88.7% (AUC = 0.872, 95%CI:0.810-0.934)，而PRAME（+）和p16(-)（意为PRAME（+）和p16(-)）对MM的敏感性和特异性分别为27.7%和100% （AUC = 0.638, 95%CI:0.555-0.722）。在肢端样本中，PRAME(+)/p16（-）对MM的特异性为94.7%，敏感性为86.9% (AUC = 0.908, 95%CI: 0.849 ~ 0.968)，对侵袭性MM的敏感性为90.9%，对侵袭前MM的敏感性为82.5%；PRAME（+）和p16（-）对MM的敏感性和特异性分别为22.6%和100% （AUC = 0.613, 95%CI: 0.513-0.714）。在非肢端样本中，PRAME(+)/p16（-）对MM的敏感性和特异性分别为82.1%和73.3% (AUC = 0.777, 95%CI: 0.622 ~ 0.933)， PRAME（+）和p16（-）对MM的敏感性和特异性分别为42.9%和100% （AUC = 0.714, 95%CI:0.564 ~ 0.864）。结论：PRAME和p16的联合免疫组化有助于黑色素细胞肿瘤的鉴别，特别是对肢端原位MM的鉴别。

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来源期刊

Diagnostic Pathology 医学-病理学

CiteScore

4.60

自引率

0.00%

发文量

审稿时长

1 months

期刊介绍： Diagnostic Pathology is an open access, peer-reviewed, online journal that considers research in surgical and clinical pathology, immunology, and biology, with a special focus on cutting-edge approaches in diagnostic pathology and tissue-based therapy. The journal covers all aspects of surgical pathology, including classic diagnostic pathology, prognosis-related diagnosis (tumor stages, prognosis markers, such as MIB-percentage, hormone receptors, etc.), and therapy-related findings. The journal also focuses on the technological aspects of pathology, including molecular biology techniques, morphometry aspects (stereology, DNA analysis, syntactic structure analysis), communication aspects (telecommunication, virtual microscopy, virtual pathology institutions, etc.), and electronic education and quality assurance (for example interactive publication, on-line references with automated updating, etc.).