Combining RNA tape stripping with dermoscopic features for melanoma identification

Terese von Knorring, Ida M. Heerfordt, Jeppe D. Andersen, Lisbet Rosenkrantz Hølmich, Katrine Karmisholt, Silje H. Omland, Frederikke F. Knudsen, Peter A. Philipsen, Mette Mogensen
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引用次数: 0

Abstract

Background

A noninvasive, accurate diagnostic method for melanoma is needed to improve early detection and decrease number of excisions. Gene expression as measured by RNA levels uses tape strips to directly assesses genetic markers from skin lesions. Commercial RNA assays show varying diagnostic accuracy in melanoma detection. Combining dermoscopic features with RNA tape strips could reduce unnecessary removal of benign lesions by increasing specificity.

Objectives

To test an RNA-based rule-out test and integrate dermoscopic features with RNA analysis to improve diagnostic accuracy of malignant melanoma (MM). Furthermore, we explore the association between RNA profiles and dermoscopic features.

Methods

Seventy patients with pigmented skin lesions suspected of being melanoma were imaged with dermoscopy and tape stripped for RNA analysis before surgical excision. The images were evaluated for seven dermoscopic features, and RNA levels of 11 genes were analyzed. A combined test using both gene expression and dermoscopic features was developed. Associations between RNA profiles and dermoscopic features were explored.

Results

Histopathology revealed 19 malignant lesions (17 MM and two basal cell carcinomas) and 51 benign lesions. The combined dermoscopy and RNA test identified all malignant lesions (100% sensitivity) based on PRAME expression, blotch and regression structures and patient age. This combined model increased specificity to 35%, compared to 24% with the original RNA rule-out test, without missing any malignant lesions. Significant differences in RNA profiles were observed for lesions expressing atypical network and regression structures.

Conclusions

Combining RNA tape stripping with dermoscopic features can reduce the removal of benign lesions by over one-third while maintaining 100% sensitivity. We found specific RNA profiles to be strongly associated with dermoscopic features, presenting a promising opportunity to integrate molecular and morphological information and provide valuable guidance for dermatologists managing atypical pigmented lesions.

Abstract Image

结合RNA胶带剥离与皮肤镜特征识别黑色素瘤
背景 需要一种无创、准确的黑色素瘤诊断方法,以提高早期发现率并减少切除次数。通过 RNA 水平测量基因表达可使用胶带直接评估皮肤病变中的遗传标记。商用 RNA 检测方法在黑色素瘤检测中的诊断准确性各不相同。将皮肤镜特征与 RNA 磁带条相结合,可以提高特异性,从而减少不必要的良性病变切除。 目的 测试一种基于 RNA 的排除测试,并将皮肤镜特征与 RNA 分析相结合,以提高恶性黑色素瘤(MM)的诊断准确性。此外,我们还探讨了 RNA 图谱与皮肤镜特征之间的关联。 方法 对 70 名疑似黑色素瘤的色素性皮肤病变患者进行皮肤镜成像,并在手术切除前剥离胶带进行 RNA 分析。根据七种皮肤镜特征对图像进行评估,并分析 11 种基因的 RNA 水平。利用基因表达和皮肤镜特征进行了综合测试。探讨了 RNA 图谱与皮肤镜特征之间的关联。 结果 组织病理学显示有 19 个恶性病变(17 个 MM 和 2 个基底细胞癌)和 51 个良性病变。根据 PRAME 表达、斑点和回归结构以及患者年龄,皮肤镜和 RNA 联合检测确定了所有恶性病变(灵敏度 100% )。与原始的 RNA 排除测试的 24% 相比,这种组合模型将特异性提高到了 35%,而且不会遗漏任何恶性病变。在表达非典型网络结构和回归结构的病变中,观察到 RNA 图谱的显著差异。 结论 将 RNA 胶带剥离与皮肤镜特征相结合,可将良性病变的去除率降低三分之一以上,同时保持 100% 的灵敏度。我们发现特定的 RNA 图谱与皮肤镜特征密切相关,这为整合分子和形态学信息提供了一个很好的机会,并为皮肤科医生处理非典型色素性病变提供了有价值的指导。
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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