Immunostain use in the diagnosis of melanomas referred to a tertiary medical center: a 15‐year retrospective review (2001–2015)

Kim, Randie H.; Meehan, Shane A

doi:10.1111/cup.12867

Cited by 24 publications

(26 citation statements)

References 23 publications

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“…Studies have shown that 95% of surveyed dermatopathologists endorse using IHC use for at least some of the melanocytic lesions encountered in practice . Kim et al found an increase in the use of IHC stains, from 5% to 25%, in melanomas referred to a tertiary center over a 10‐year period . Other investigators have found that IHC stains contributed to the diagnosis, or added information, in 33% of review cases although exactly what was added and the value of these additions was not expounded on …”

Section: Discussionmentioning

confidence: 99%

Immunohistochemistry utilization in the diagnosis of melanoma

Dinehart

Sukpraprut‐Braaten³

et al. 2020

J Cutan Pathol

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Background: The use of immunohistochemical (IHC) stains in dermatopathology is commonplace; however, little is known regarding utilization trends in melanoma diagnosis. Current Medicare local coverage determinations (LCDs) state that most pigmented lesions, including melanoma, can be diagnosed using H&E alone.Methods: Histopathology reports for all biopsy-proven melanomas excised between January 1, 2017 and June 30, 2018, at a single dermatology clinic, were identified with the following parameters abstracted: laboratory/dermatopathologist rendering the diagnosis, whether IHC was performed, type/number of stains utilized, presence/depth of invasion, and melanoma subtype. The association of characteristics with IHC utilization was evaluated using χ 2 test for categorical variables.Results: Three hundred and fifty six eligible melanomas were identified. IHC was employed in 228 (64%) of the diagnoses. Invasive melanoma was diagnosed in 199 cases (55.9%) while 157 (44.1%) were identified as melanoma in situ (MIS). Of the 228 that utilized IHC, 117 were performed on invasive melanoma (58.8%) and 111 were performed on MIS (70.7%).Conclusion: Our findings suggest a higher IHC usage for the diagnosis of melanoma than previously reported. Existing LCDs regarding IHC utilization in melanoma do not reflect the current state of practice. Further investigation regarding IHC utilization and the development of appropriate-use criteria for melanoma IHC is necessary. K E Y W O R D Simmunohistochemistry, local coverage determination, melanoma, utilization

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Section: Discussionmentioning

confidence: 99%

Immunohistochemistry utilization in the diagnosis of melanoma

Dinehart

Sukpraprut‐Braaten³

et al. 2020

J Cutan Pathol

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“…33 To improve detection and diagnosis of melanoma (as well as other cancers), non-invasive imaging technology prebiopsy and more quantitative techniques post-biopsy, such as fluorescence in situ hybridization (FISH), comparative genomic hybridization (CGH), sequencing, mass spectrometry (MS) and IHC are being used more frequently. 34,35 Non-invasive imaging for melanoma detection Recent technological advancements have resulted in the emergence of non-invasive imaging technology to detect melanoma. Several smartphone applications, such as SkinVision, UMSkinCheck, and MoleScope, have been developed with purported goals of wide-spread accessibility, cost-effective screening, and ultimately increased early detection for patients.…”

Section: Diagnosis and Prognosis Of Melanomamentioning

confidence: 99%

“…[47][48][49][50] Moreover, as the molecular mechanisms driving melanomagenesis have become better understood, researchers and clinicians have utilized molecular biomarkers to assist in recognition of melanoma, and immunohistochemistry (IHC) has been increasingly utilized in the interpretation of difficult cases. 34 IHC is the most common ancillary technique used by pathologists to assist in the diagnosis of melanoma as it is readily available in most laboratories, relatively inexpensive, and reliable and reproducible. Therefore, it is unsurprising that the use of IHC for the diagnosis of melanoma has significantly increased over the last 20 years.…”

Section: Clinical Markersmentioning

confidence: 99%

“…Therefore, it is unsurprising that the use of IHC for the diagnosis of melanoma has significantly increased over the last 20 years. 34 For melanoma, there are two types of biomarkers most commonly used for diagnostic and prognostic purposes: melanocytic markers and proliferative markers. 23,26,33,34,[51][52][53][54][55][56] Melanocytic markers are used to determine if an ambiguous lesion is melanocytic in origin and tend to be proteins involved in melanin synthesis, melanosomes biogenesis, or melanocyte differentiation, while proliferation makers are used to evaluate cell cycle activity in a lesion.…”

Section: Clinical Markersmentioning

confidence: 99%

“…34 For melanoma, there are two types of biomarkers most commonly used for diagnostic and prognostic purposes: melanocytic markers and proliferative markers. 23,26,33,34,[51][52][53][54][55][56] Melanocytic markers are used to determine if an ambiguous lesion is melanocytic in origin and tend to be proteins involved in melanin synthesis, melanosomes biogenesis, or melanocyte differentiation, while proliferation makers are used to evaluate cell cycle activity in a lesion. 54,56 Currently, the determination of tumor proliferation is typically done counting mitotic figures (mitosis/mm 2 ); however, recent studies have shown that IHC detection of proliferative markers can be a robust indicator of proliferative activity with prognostic import.…”

Section: Clinical Markersmentioning

confidence: 99%

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Current state of melanoma diagnosis and treatment

Davis

Shalin

Tackett

2019

Cancer Biology & Therapy

646

463

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Melanoma is the deadliest form of skin cancer. In the early stages, melanoma can be treated successfully with surgery alone and survival rates are high, but after metastasis survival rates drop significantly. Therefore, early and correct diagnosis is key for ensuring patients have the best possible prognosis. Melanoma misdiagnosis accounts for more pathology and dermatology malpractice claims than any cancer other than breast cancer, as an early misdiagnosis can significantly reduce a patient’s chances of survival. As far as treatment for metastatic melanoma goes, there have been several new drugs developed over the last 10 years that have greatly improved the prognosis of patients with metastatic melanoma, however, a majority of patients do not show a lasting response to these treatments. Thus, new biomarkers and drug targets are needed to improve the accuracy of melanoma diagnosis and treatment. This article will discuss the major advancements of melanoma diagnosis and treatment from antiquity to the present day.

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Immunohistochemistry for Diagnosing Melanoma in Older Adults

Ojukwu,

Eguchi,

Adamson

et al. 2024

JAMA Dermatol

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ImportancePathologic assessment to diagnose skin biopsies, especially for cutaneous melanoma, can be challenging, and immunohistochemistry (IHC) staining has the potential to aid decision-making. Currently, the temporal trends regarding the use of IHC for the examination of skin biopsies on a national level have not been described.ObjectiveTo illustrate trends in the use of IHC for the examination of skin biopsies in melanoma diagnoses.Design, Setting, and ParticipantsA retrospective cross-sectional study was conducted to examine incident cases of melanoma diagnosed between January 2000 and December 2017. The analysis used the SEER-Medicare linked database, incorporating data from 17 population-based registries. The study focused on incident cases of in situ or malignant melanoma of the skin diagnosed in patients 65 years or older. Data were analyzed between August 2022 and November 2023.Main Outcomes and MeasuresThe main outcomes encompassed the identification of claims for IHC within the month of melanoma diagnoses and extending up to 14 days into the month following diagnosis. The SEER data on patients with melanoma comprised demographic, tumor, and area-level characteristics.ResultsThe final sample comprised 132 547 melanoma tumors in 116 117 distinct patients. Of the 132 547 melanoma diagnoses meeting inclusion criteria from 2000 to 2017, 43 396 cases had accompanying IHC claims (33%). Among these cases, 28 298 (65%) were diagnosed in male patients, 19 019 (44%) were diagnosed in patients aged 65 years to 74 years, 16 444 (38%) in patients aged 75 years to 84 years, and 7933 (18%) in patients aged 85 years and older. In 2000, 11% of melanoma cases had claims for IHC at or near the time of diagnosis. This proportion increased yearly, with 51% of melanoma cases having associated IHC claims in 2017. Increasing IHC use is observed for all stages of melanoma, including in situ melanoma. Claims for IHC in melanomas increased in all 17 SEER registries but at different rates. In 2017, the use of IHC for melanoma diagnosis ranged from 39% to 68% across registries.Conclusions and RelevanceConsidering the dramatically rising and variable use of IHC in diagnosing melanoma by pathologists demonstrated in this retrospective cross-sectional study, further investigation is warranted to understand the clinical utility and discern when IHC most improves diagnostic accuracy or helps patients.

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Immunostain use in the diagnosis of melanomas referred to a tertiary medical center: a 15‐year retrospective review (2001–2015)

Abstract: Immunostain use in the diagnosis of melanoma has increased significantly in the past 15 years for reasons that remain unclear.

Cited by 24 publications

References 23 publications

Immunohistochemistry utilization in the diagnosis of melanoma

Immunohistochemistry utilization in the diagnosis of melanoma

Current state of melanoma diagnosis and treatment

Immunohistochemistry for Diagnosing Melanoma in Older Adults

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