PRAME Expression in Melanocytic Tumors
PRAME Expression in Melanocytic Tumors
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DOI：
10.1097/pas.0000000000001134
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发表时间：
2018-11-01
影响因子：
5.6
通讯作者：
Busam, Klaus J.
中科院分区：
文献类型：
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作者：
Lezcano, Cecilia;Jungbluth, Achim A.;Busam, Klaus J.
PRAME（黑色素瘤优先表达抗原）是一种黑色素瘤相关抗原，由黑色素瘤患者的自体T细胞分离。虽然PRAME mRNA在皮肤和眼部黑色素瘤中频繁表达，但对PRAME蛋白在黑色素细胞肿瘤中的表达知之甚少。在这项研究中，我们检测了400例黑色素细胞肿瘤中PRAME的免疫组织化学表达，其中包括155例原发性黑色素瘤和100例转移性黑色素瘤，以及145例黑色素细胞痣。在87%的转移性黑色素瘤和83.2%的原发性黑色素瘤中发现弥漫性核免疫反应性PRAME。在黑色素瘤亚型中，PRAME在94.4%的肢端黑色素瘤、92.5%的浅表扩散性黑色素瘤、90%的结节性黑色素瘤、88.6%的小晶体恶性黑色素瘤和35%的韧带增生性黑色素瘤中弥漫性表达。当原位和非结缔组织增生的侵袭性黑色素瘤成分存在时，PRAME在两者中均有表达。在140例皮肤黑素细胞痣中，86.4% PRAME完全阴性。PRAME的免疫反应性见于13.6%的皮肤痣，包括发育不良痣、常见获得性痣、创伤性/复发性痣和Spitz痣，尽管通常仅在一小部分病变黑色素细胞亚群中可见。在太阳小痣和良性非病变皮肤中也发现了罕见的分离的具有PRAME免疫反应性的结缔组织黑色素细胞。我们的结果表明，PRAME表达的免疫组织化学分析可能有助于诊断目的，以支持黑色素瘤的疑似诊断。对于已知prame阳性黑色素瘤的边缘评估也可能有价值，但其在痣、太阳痣和良性非病变皮肤中的表达可能是一个陷阱，值得进一步研究以更好地评估该标志物的潜在临床应用。
PRAME (PReferentially expressed Antigen in MElanoma) is a melanoma-associated antigen that was isolated by autologous T cells in a melanoma patient. While frequent PRAME mRNA expression is well documented in cutaneous and ocular melanomas, little is known about PRAME protein expression in melanocytic tumors. In this study we examined the immunohistochemical expression of PRAME in 400 melanocytic tumors, including 155 primary and 100 metastatic melanomas, and 145 melanocytic nevi. Diffuse nuclear immunoreactivity for PRAME was found in 87% of metastatic and 83.2% of primary melanomas. Among melanoma subtypes, PRAME was diffusely expressed in 94.4% of acral melanomas, 92.5% of superficial spreading melanomas, 90% of nodular melanomas, 88.6% of lentigo maligna melanomas, and 35% of desmoplastic melanomas. When in situ and nondesmoplastic invasive melanoma components were present, PRAME expression was seen in both. Of the 140 cutaneous melanocytic nevi, 86.4% were completely negative for PRAME. Immunoreactivity for PRAME was seen, albeit usually only in a minor subpopulation of lesional melanocytes, in 13.6% of cutaneous nevi, including dysplastic nevi, common acquired nevi, traumatized/recurrent nevi, and Spitz nevi. Rare isolated junctional melanocytes with immunoreactivity for PRAME were also seen in solar lentigines and benign nonlesional skin. Our results suggest that immunohistochemical analysis for PRAME expression may be useful for diagnostic purposes to support a suspected diagnosis of melanoma. It may also be valuable for margin assessment of a known PRAME-positive melanoma, but its expression in nevi, solar lentigines, and benign nonlesional skin can represent a pitfall and merits further investigations to better assess the potential clinical utility of this marker.