文章：

皮肤有丝分裂与恶性雀斑样痣黑色素瘤手术负担相关：PRAME用于切缘评估

Dermal Mitoses Correlate with Surgical Burden in Lentigo Maligna Melanoma: PRAME for Margin Assessment

原文发布日期：24 September 2025

DOI: 10.3390/cancers17193112

类型: Article

开放获取: 是

英文摘要：

Background/Introduction:Margin assessment in Lentigo maligna (LM) and Lentigo maligna melanoma (LMM) is challenging. Many of these lesions require extensive surgical procedures for R0 resections with unclear histological and clinical features predicting lateral spread. Recently, PRAME was described as a useful antibody to determine margins in these entities. However, several questions, like acceptable PRAME+cell number and density in resection margins and optimal safety margins, especially in head and neck areas, remain.Methods:We analyzed cases of LMIS and LMM since the introduction of PRAME and before the introduction of PRAME, with more than 171 cases in total. We re-stained security margins with PRAME.Results:We identified a correlation between reported dermal mitoses in LMM and the number of surgical procedures. In many LMM cases before the widespread use of PRAME from our archives, we detected a high density of PRAME+cells in melanoma security margins previously labeled tumor-free. No local recurrence could be identified in these cases, with the caveat of limited follow-up and small case numbers.Conclusions:Our findings raise important questions regarding margin assessment with PRAME and the reporting of residual cells in margins.

摘要翻译： 

背景/引言：恶性雀斑样痣（LM）与恶性雀斑样痣黑色素瘤（LMM）的边缘评估具有挑战性。许多此类病变需要进行广泛的手术操作以实现R0切除，但其组织学和临床特征在预测侧向扩散方面尚不明确。近期，PRAME被报道为一种有助于确定此类病变边缘的有用抗体。然而，关于切除边缘中可接受的PRAME阳性细胞数量与密度、以及最佳安全边缘（尤其在头颈部区域）等问题仍未解决。 方法：我们分析了自PRAME应用前至应用后的LMIS与LMM病例，总计超过171例。我们使用PRAME对安全边缘进行了重新染色。 结果：我们发现LMM中报告的皮肤有丝分裂数量与手术操作次数存在相关性。在档案中PRAME广泛应用前的许多LMM病例中，我们检测到先前标记为无肿瘤的黑色素瘤安全边缘存在高密度的PRAME阳性细胞。尽管存在随访时间有限和病例数较少的局限性，这些病例中均未发现局部复发。 结论：我们的研究结果对使用PRAME进行边缘评估以及边缘残留细胞的报告提出了重要问题。

原文链接：

Dermal Mitoses Correlate with Surgical Burden in Lentigo Maligna Melanoma: PRAME for Margin Assessment