Ancillary immunohistochemistry testing for loss of p16 in melanoma: A systematic review and meta-analysis of diagnostic accuracy studies

IF 1.6 4区医学 Q3 DERMATOLOGY

Journal of Cutaneous Pathology Pub Date : 2024-09-10 DOI:10.1111/cup.14717

Shruti S. Chinchanikar, Garth R. Fraga

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引用次数: 0

Abstract

Background

Ancillary immunohistochemistry testing for p16 loss has been proposed as a diagnostic tool for melanoma, but its accuracy remains uncertain.

Methods

A systematic review and meta-analysis were conducted on 26 studies involving 979 melanomas and 974 nevi.

Results

Through bivariate analysis of data across all cut-off values, the sensitivity and specificity were calculated to be 0.55 (95% confidence interval [CI]: 0.38, 0.70) and 0.85 (95% CI: 0.70, 0.94), respectively. Summary estimates of diagnostic accuracy fell below recommended thresholds for effective tests, but subgroup analysis suggested that p16 loss could aid in diagnosing ambiguous lesions as melanoma in certain scenarios. However, the presence of p16 expression in these contexts does not definitively rule out melanoma. The findings were limited by underpowered exploratory study designs at risk for bias in patient selection and test interpretation.

Conclusions

While the use of p16 immunohistochemistry for detecting melanoma is not universally reliable, it may serve as a confirmatory test in differential diagnoses involving common, congenital, acral, Spitz, and deep penetrating nevi. Nevertheless, further studies are needed to validate its utility. Until then, the application of p16 immunohistochemistry in melanoma diagnosis should be regarded as experimental.

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黑色素瘤 p16 缺失的辅助免疫组化检测：诊断准确性研究的系统回顾和荟萃分析

方法对涉及979例黑色素瘤和974例痣的26项研究进行了系统回顾和荟萃分析。结果通过对所有临界值的数据进行双变量分析，计算出敏感性和特异性分别为0.55（95%置信区间[CI]：0.38，0.70）和0.85（95% CI：0.70，0.94）。诊断准确率的总估计值低于推荐的有效检测阈值，但亚组分析表明，在某些情况下，p16 缺失有助于将模糊病变诊断为黑色素瘤。不过，在这些情况下出现 p16 表达并不能明确排除黑色素瘤。结论虽然使用 p16 免疫组化检测黑色素瘤并不普遍可靠，但在涉及普通痣、先天性痣、尖锐痣、Spitz 痣和深部穿透性痣的鉴别诊断中，它可作为一种确诊检验。不过，还需要进一步的研究来验证其实用性。在此之前，p16 免疫组化在黑色素瘤诊断中的应用应被视为试验性的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cutaneous Pathology 医学-病理学

CiteScore

3.20

自引率

5.90%

发文量

174

审稿时长

3-8 weeks

期刊介绍： Journal of Cutaneous Pathology publishes manuscripts broadly relevant to diseases of the skin and mucosae, with the aims of advancing scientific knowledge regarding dermatopathology and enhancing the communication between clinical practitioners and research scientists. Original scientific manuscripts on diagnostic and experimental cutaneous pathology are especially desirable. Timely, pertinent review articles also will be given high priority. Manuscripts based on light, fluorescence, and electron microscopy, histochemistry, immunology, molecular biology, and genetics, as well as allied sciences, are all welcome, provided their principal focus is on cutaneous pathology. Publication time will be kept as short as possible, ensuring that articles will be quickly available to all interested in this speciality.