慢速莫氏活检边缘评估白斑和白斑黑色素瘤中的 PRAME 和 Melan A 双免疫组化标记

R. Salih, F. Ismail, G. E. Orchard
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摘要

导言:恶性色素痣(LM)和恶性黑色素瘤(LMM)主要发生在老年患者的头颈部,表现为边界不清、难以辨认的色素性病变。由于这些特点,为彻底切除而确定手术边缘的工作仍然十分复杂。手术边缘的形态学检查是确定 LM/LMM 治疗成功与否的关键形式,也是慢速莫氏显微手术(SMMS)方法提供更佳边缘控制的基础。最近的评估探索了免疫组化(IHC)标记的使用,如黑色素瘤中的优先表达抗原(PRAME),以帮助LM/LMM和边缘评估,利用PRAME标记在恶性黑色素细胞肿瘤中的选择性:方法:采用一种新颖的双标记(DL)方法,同时结合PRAME和MelanA IHC,以进一步最大限度地提高PRAME在评估SMMS活检组织中LM/LMM的临床适用性。评估涉及51个样本,比较了新型DL与各自的单标记(SL)IHC切片的结果:结果:研究结果表明,在所有测试样本中,DL 方法与 SL 切片之间的一致性高达 96.1%。基准 PRAME SL 在 SMMS 标本中的灵敏度为 91.3%,在组织学证实的阳性边缘中的灵敏度为 67.9%:本研究强调了 PRAME IHC 以及 PRAME DL 作为辅助工具在 SMMS 样本分期切除边缘黑色素细胞肿瘤评估中的实用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Double Immunohistochemical Labelling of PRAME and Melan A in Slow Mohs Biopsy Margin Assessment of Lentigo Maligna and Lentigo Maligna Melanoma
Introduction: Lentigo maligna (LM) and lentigo maligna melanoma (LMM) predominantly affect the head and neck areas in elderly patients, presenting as challenging ill-defined pigmented lesions with indistinct borders. Surgical margin determination for complete removal remains intricate due to these characteristics. Morphological examination of surgical margins is the key form of determining successful treatment in LM/LMM and underpin the greater margin control provided through the Slow Mohs micrographic surgery (SMMS) approach. Recent assessments have explored the use of immunohistochemistry (IHC) markers, such as Preferentially Expressed Antigen in Melanoma (PRAME), to aid in LM/LMM and margin evaluation, leveraging the selectivity of PRAME labelling in malignant melanocytic neoplasms.Methods: A Novel double-labelling (DL) method incorporating both PRAME and MelanA IHC was employed to further maximise the clinical applicability of PRAME in the assessment of LM/LMM in SMMS biopsies. The evaluation involved 51 samples, comparing the results of the novel DL with respective single-labelling (SL) IHC slides.Results: The findings demonstrated a significant agreement of 96.1% between the DL method and SL slides across the tested samples. The benchmark PRAME SL exhibited a sensitivity of 91.3% in the SMMS specimens and 67.9% in histologically confirmed positive margins.Discussion: This study highlights the utility of PRAME IHC and by extension PRAME DL as an adjunctive tool in the assessment of melanocytic tumours within staged excision margins in SMMS samples.
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