文章：

PRAME是诊断痣相关皮肤黑色素瘤的有效工具

PRAME Is an Effective Tool for the Diagnosis of Nevus-Associated Cutaneous Melanoma

原文发布日期：9 January 2024

DOI: 10.3390/cancers16020278

类型: Article

开放获取: 是

英文摘要：

(1) Background: Nevus-associated cutaneous melanoma (CM) is relatively common in the clinical practice of dermatopathologists. The correct diagnosis and staging of nevus-associated cutaneous melanoma (CM) mainly relies on the correct discrimination between benign and malignant cells. Recently, PRAME has emerged as a promising immunohistochemical marker of malignant melanocytes. (2) Methods: PRAME immunohistochemistry (IHC) was performed in 69 cases of nevus-associated CMs. Its expression was evaluated using a score ranging from 0 to 4+ based on the percentage of melanocytic cells with a nuclear expression. PRAME IHC sensitivity, specificity, positive predictive values, and negative predictive values were assessed. Furthermore, the agreement between morphological data and PRAME expression was evaluated for the diagnosis of melanoma components and nevus components. (3) Results: PRAME IHC showed a sensitivity of 59%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 71%. The diagnostic agreement between morphology and PRAME IHC was fair (Cohen’s Kappa: 0.3); the diagnostic agreement regarding the benign nevus components associated with CM was perfect (Cohen’s Kappa: 1.0). PRAME was significantly more expressed in thick invasive CMs than in thin cases (p= 0.02). (4) Conclusions: PRAME IHC should be considered for the diagnostic evaluation of nevus-associated CM and is most useful in cases of thick melanomas. Pathologists should carefully consider that a PRAME-positive cellular population within the context of a nevus could indicate a CM associated with the nevus. A negative result does not rule out this possibility.

摘要翻译： 

(1) 背景：在皮肤病理学临床实践中，痣相关性皮肤黑色素瘤较为常见。其正确诊断与分期主要依赖于良恶性细胞的准确鉴别。近年来，PRAME已成为恶性黑素细胞极具潜力的免疫组织化学标记物。(2) 方法：对69例痣相关性皮肤黑色素瘤进行PRAME免疫组化检测。根据细胞核表达PRAME的黑素细胞百分比，采用0至4+评分系统评估其表达水平。计算PRAME免疫组化的敏感性、特异性、阳性预测值及阴性预测值。进一步评估形态学诊断与PRAME表达在黑色素瘤成分和痣成分判定中的一致性。(3) 结果：PRAME免疫组化检测敏感性为59%，特异性100%，阳性预测值100%，阴性预测值71%。形态学诊断与PRAME免疫组化结果一致性一般（Cohen's Kappa系数：0.3）；而在伴发黑色素瘤的良性痣成分判定中，两者具有完全一致性（Cohen's Kappa系数：1.0）。PRAME在厚浸润性黑色素瘤中的表达显著高于薄型病例（p=0.02）。(4) 结论：PRAME免疫组化应纳入痣相关性皮肤黑色素瘤的诊断评估体系，在厚型黑色素瘤中应用价值尤为显著。病理医师需特别注意：痣背景中出现PRAME阳性细胞群可能提示存在伴发黑色素瘤，但阴性结果不能排除这种可能性。

原文链接：

PRAME Is an Effective Tool for the Diagnosis of Nevus-Associated Cutaneous Melanoma