Shedding light on PRAME expression in dysplastic nevi: a cohort study

Innocenti, Lorenzo; Scarpitta, Rosa; Corraro, Serena; Ortenzi, Valerio; Bonadio, Angelo G.; Loggini, Barbara; De Ieso, Katia; Naccarato, Antonio G.; Fanelli, Giuseppe N.; Scatena, Cristian

doi:10.1007/s00428-023-03720-5

Virchows Arch

2023

DOI: 10.1007/s00428-023-03720-5

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Shedding light on PRAME expression in dysplastic nevi: a cohort study

Lorenzo Innocenti,

Rosa Scarpitta,

Serena Corraro

et al.

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2024

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Cited by 3 publications

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PRAME immunohistochemistry distinguishes nodal nevi from metastatic melanoma

da Silveira,

Junior,

de Souza Campos

et al. 2024

Surg Exp Pathol

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Background Preferentially expressed antigen in melanoma (PRAME) is a promising immunohistochemical marker for distinguishing benign from malignant melanocytic lesions in lymph node deposits. Objective To evaluate PRAME expression in metastatic melanomas and nevi found in the sentinel lymph nodes of patients with primary melanoma. Methods Thirty patients, comprising 15 nodal nevi and 15 metastatic melanomas, were immunohistochemically analyzed for PRAME expression. Nuclear expression was scored as 0–25%, > 25–50%, > 50–75% or > 75% in tumor cells. The sensitivity, specificity, and positive and negative predictive values were calculated considering nuclear expression of PRAME > 75% as positive cases. Results Cases previously diagnosed as nodal nevi were uniformly negative for PRAME. Conversely, all cases diagnosed as melanoma showed PRAME expression in more than 50% of the cells. Twelve cases showed expression above 75% of cells and were considered positive for calculations, resulting in sensitivity and specificity rates of 80% and 100%, respectively, with corresponding positive and negative predictive values of 100% and 83%. Conclusions A high level of PRAME immunoreactivity was identified in metastatic melanoma, suggesting that PRAME is a useful analytical tool for confirming the diagnosis of melanoma in a melanocytic nodal deposit.

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PRAME immunohistochemistry distinguishes nodal nevi from metastatic melanoma

da Silveira,

Junior,

de Souza Campos

et al. 2024

Surg Exp Pathol

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PRAME Immunohistochemistry in Thin Melanomas Compared to Melanocytic Nevi

Zboraș,

Ungureanu,

Șenilă

et al. 2024

Diagnostics

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PRAME (PReferentially expressed Antigen in Melanoma) immunohistochemistry has proven helpful in distinguishing malignant from benign melanocytic tumors. We studied PRAME IHC expression in 46 thin melanomas and 39 melanocytic nevi, mostly dysplastic nevi. Twenty-six percent (26.09%) of the melanomas showed diffuse PRAME staining in over 76% of the tumor cells (4+), and 34.78% of the melanomas showed PRAME expression in over 51% of the tumor cells (3+ or 4+), while 8% were entirely negative for PRAME. No melanocytic nevi were PRAME 4+ or 3+. More than half of the nevi (64%) were entirely negative for PRAME staining, and 36% of the nevi showed staining expression in 1–25% (1+) or 26–50% of the cells (2+). No nevi were stained with a color intensity of 3, while 16.67% of the melanomas were stained with this color intensity. Most nevi (78.57%) were stained with an intensity of 1. With a lower positivity threshold, sensitivity increases with still reasonable specificity. The best accuracy was obtained for the 2+ positivity threshold. In conclusion, PRAME staining helps distinguish thin melanomas from dysplastic nevi. However, the threshold of positivity should be lowered in order not to miss thin melanomas.

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The Impact of PRAME Expression on Breslow Depth in Melanoma Arising in Dysplastic Nevi in a Large Multi-State Dermatology Group

Chisholm

2024

JDR

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Background: PRAME immunohistochemistry has been reported to be positive in at least 83.2% of invasive melanomas while being positive in no more than 13.6% of benign nevi. Melanoma may arise within pre-existing nevi or dysplastic nevi and PRAME could potentially have an effect on the measured Breslow depth. Objective: We performed a retrospective review of invasive melanoma cases diagnosed over a 4 year period to evaluate if the use of PRAME had an impact on Breslow depth. Methods: Diagnostic reports were reviewed to separate out cases of invasive melanoma that arose in precursor nevi or dysplastic nevi. The final sample size is 152 cases. Results: The average melanoma depth in the PRAME group was 0.51 mm, while being 0.68 mm in the no PRAME group (p<0.05). The pathologic stage was unchanged in all cases. Limitations: The pathology reports were made by multiple dermatopathologists and therefore reporting of precursor nevi on the reports may not be entirely uniform. Conclusion: PRAME does impact the Breslow depth of invasive melanoma when arising in precursor nevi, but significant alterations in the pathologic stage were not observed.

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Shedding light on PRAME expression in dysplastic nevi: a cohort study

Cited by 3 publications

References 35 publications

PRAME immunohistochemistry distinguishes nodal nevi from metastatic melanoma

PRAME immunohistochemistry distinguishes nodal nevi from metastatic melanoma

PRAME Immunohistochemistry in Thin Melanomas Compared to Melanocytic Nevi

The Impact of PRAME Expression on Breslow Depth in Melanoma Arising in Dysplastic Nevi in a Large Multi-State Dermatology Group

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