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Lee J, Beirami MJ, Ebrahimpour R, Puyana C, Tsoukas M, Avanaki K. Optical coherence tomography confirms non-malignant pigmented lesions in phacomatosis pigmentokeratotica using a support vector machine learning algorithm. Skin Res Technol 2023; 29:e13377. [PMID: 37357662 PMCID: PMC10228288 DOI: 10.1111/srt.13377] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/19/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Phacomatosis pigmentokeratotica (PPK), an epidermal nevus syndrome, is characterized by the coexistence of nevus spilus and nevus sebaceus. Within the nevus spilus, an extensive range of atypical nevi of different morphologies may manifest. Pigmented lesions may fulfill the ABCDE criteria for melanoma, which may prompt a physician to perform a full-thickness biopsy. MOTIVATION Excisions result in pain, mental distress, and physical disfigurement. For patients with a significant number of nevi with morphologic atypia, it may not be physically feasible to biopsy a large number of lesions. Optical coherence tomography (OCT) is a non-invasive imaging modality that may be used to visualize non-melanoma and melanoma skin cancers. MATERIALS AND METHOD In this study, we used OCT to image pigmented lesions with morphologic atypia in a patient with PPK and assessed their quantitative optical properties compared to OCT cases of melanoma. We implement a support vector machine learning algorithm with Gabor wavelet transformation algorithm during post-image processing to extract optical properties and calculate attenuation coefficients. RESULTS The algorithm was trained and tested to extract and classify textural data. CONCLUSION We conclude that implementing this post-imaging machine learning algorithm to OCT images of pigmented lesions in PPK has been able to successfully confirm benign optical properties. Additionally, we identified remarkable differences in attenuation coefficient values and tissue optical characteristics, further defining separating benign features of pigmented lesions in PPK from malignant features.
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Affiliation(s)
- Jenna Lee
- Department of DermatologyUniversity of Illinois‐ChicagoChicagoIllinoisUSA
| | - Mohammad Javad Beirami
- Center for Cognitive ScienceInstitute for Convergence Science and Technology (ICST)Sharif University of TechnologyTehranIslamic Republic of Iran
| | - Reza Ebrahimpour
- Center for Cognitive ScienceInstitute for Convergence Science and Technology (ICST)Sharif University of TechnologyTehranIslamic Republic of Iran
- Department of Computer EngineeringShahid Rajaee Teacher Training UniversityTehranIslamic Republic of Iran
- School of Cognitive SciencesInstitute for Research in Fundamental Sciences (IPM)TehranIslamic Republic of Iran
| | - Carolina Puyana
- Department of DermatologyUniversity of Illinois‐ChicagoChicagoIllinoisUSA
| | - Maria Tsoukas
- Department of DermatologyUniversity of Illinois‐ChicagoChicagoIllinoisUSA
| | - Kamran Avanaki
- Department of DermatologyUniversity of Illinois‐ChicagoChicagoIllinoisUSA
- Department of Biomedical EngineeringUniversity of Illinois‐ChicagoChicagoIllinoisUSA
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Hessler M, Jalilian E, Xu Q, Reddy S, Horton L, Elkin K, Manwar R, Tsoukas M, Mehregan D, Avanaki K. Melanoma Biomarkers and Their Potential Application for In Vivo Diagnostic Imaging Modalities. Int J Mol Sci 2020; 21:E9583. [PMID: 33339193 PMCID: PMC7765677 DOI: 10.3390/ijms21249583] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/09/2020] [Accepted: 12/12/2020] [Indexed: 12/16/2022] Open
Abstract
Melanoma is the deadliest form of skin cancer and remains a diagnostic challenge in the dermatology clinic. Several non-invasive imaging techniques have been developed to identify melanoma. The signal source in each of these modalities is based on the alteration of physical characteristics of the tissue from healthy/benign to melanoma. However, as these characteristics are not always sufficiently specific, the current imaging techniques are not adequate for use in the clinical setting. A more robust way of melanoma diagnosis is to "stain" or selectively target the suspect tissue with a melanoma biomarker attached to a contrast enhancer of one imaging modality. Here, we categorize and review known melanoma diagnostic biomarkers with the goal of guiding skin imaging experts to design an appropriate diagnostic tool for differentiating between melanoma and benign lesions with a high specificity and sensitivity.
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Affiliation(s)
- Monica Hessler
- Department of Biomedical Engineering, Wayne State University, Detroit, MI 48201, USA; (M.H.); (Q.X.); (S.R.); (L.H.); (K.E.); (R.M.)
- Department of Dermatology, School of Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USA;
| | - Elmira Jalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60607, USA;
| | - Qiuyun Xu
- Department of Biomedical Engineering, Wayne State University, Detroit, MI 48201, USA; (M.H.); (Q.X.); (S.R.); (L.H.); (K.E.); (R.M.)
| | - Shriya Reddy
- Department of Biomedical Engineering, Wayne State University, Detroit, MI 48201, USA; (M.H.); (Q.X.); (S.R.); (L.H.); (K.E.); (R.M.)
| | - Luke Horton
- Department of Biomedical Engineering, Wayne State University, Detroit, MI 48201, USA; (M.H.); (Q.X.); (S.R.); (L.H.); (K.E.); (R.M.)
- Department of Dermatology, School of Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USA;
| | - Kenneth Elkin
- Department of Biomedical Engineering, Wayne State University, Detroit, MI 48201, USA; (M.H.); (Q.X.); (S.R.); (L.H.); (K.E.); (R.M.)
- Department of Dermatology, School of Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USA;
| | - Rayyan Manwar
- Department of Biomedical Engineering, Wayne State University, Detroit, MI 48201, USA; (M.H.); (Q.X.); (S.R.); (L.H.); (K.E.); (R.M.)
- Richard and Loan Hill Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Maria Tsoukas
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL 60607, USA;
| | - Darius Mehregan
- Department of Dermatology, School of Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USA;
| | - Kamran Avanaki
- Richard and Loan Hill Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL 60607, USA;
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Gartrell RD, Marks DK, Hart TD, Li G, Davari DR, Wu A, Blake Z, Lu Y, Askin KN, Monod A, Esancy CL, Stack EC, Jia DT, Armenta PM, Fu Y, Izaki D, Taback B, Rabadan R, Kaufman HL, Drake CG, Horst BA, Saenger YM. Quantitative Analysis of Immune Infiltrates in Primary Melanoma. Cancer Immunol Res 2018; 6:481-493. [PMID: 29467127 DOI: 10.1158/2326-6066.cir-17-0360] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 11/06/2017] [Accepted: 02/15/2018] [Indexed: 01/08/2023]
Abstract
Novel methods to analyze the tumor microenvironment (TME) are urgently needed to stratify melanoma patients for adjuvant immunotherapy. Tumor-infiltrating lymphocyte (TIL) analysis, by conventional pathologic methods, is predictive but is insufficiently precise for clinical application. Quantitative multiplex immunofluorescence (qmIF) allows for evaluation of the TME using multiparameter phenotyping, tissue segmentation, and quantitative spatial analysis (qSA). Given that CD3+CD8+ cytotoxic lymphocytes (CTLs) promote antitumor immunity, whereas CD68+ macrophages impair immunity, we hypothesized that quantification and spatial analysis of macrophages and CTLs would correlate with clinical outcome. We applied qmIF to 104 primary stage II to III melanoma tumors and found that CTLs were closer in proximity to activated (CD68+HLA-DR+) macrophages than nonactivated (CD68+HLA-DR-) macrophages (P < 0.0001). CTLs were further in proximity from proliferating SOX10+ melanoma cells than nonproliferating ones (P < 0.0001). In 64 patients with known cause of death, we found that high CTL and low macrophage density in the stroma (P = 0.0038 and P = 0.0006, respectively) correlated with disease-specific survival (DSS), but the correlation was less significant for CTL and macrophage density in the tumor (P = 0.0147 and P = 0.0426, respectively). DSS correlation was strongest for stromal HLA-DR+ CTLs (P = 0.0005). CTL distance to HLA-DR- macrophages associated with poor DSS (P = 0.0016), whereas distance to Ki67- tumor cells associated inversely with DSS (P = 0.0006). A low CTL/macrophage ratio in the stroma conferred a hazard ratio (HR) of 3.719 for death from melanoma and correlated with shortened overall survival (OS) in the complete 104 patient cohort by Cox analysis (P = 0.009) and merits further development as a biomarker for clinical application. Cancer Immunol Res; 6(4); 481-93. ©2018 AACR.
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Affiliation(s)
- Robyn D Gartrell
- Departments of Pediatrics, Pediatric Hematology/Oncology and Medicine, Hematology/Oncology, Columbia University Medical Center/New York Presbyterian, New York, New York
| | - Douglas K Marks
- Department of Medicine, Division of Hematology/Oncology, Columbia University Medical Center/New York Presbyterian, New York, New York
| | - Thomas D Hart
- Columbia University, Columbia College, New York, New York
| | - Gen Li
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | | | - Alan Wu
- Mailman School of Public Health, Columbia University, New York, New York
| | - Zoë Blake
- Department of Medicine, Division of Hematology/Oncology, Columbia University Medical Center/New York Presbyterian, New York, New York
| | - Yan Lu
- Department of Medicine, Division of Hematology/Oncology, Columbia University Medical Center/New York Presbyterian, New York, New York
| | | | - Anthea Monod
- Department of Systems Biology, Columbia University, New York, New York
| | - Camden L Esancy
- Department of Medicine, Division of Hematology/Oncology, Columbia University Medical Center/New York Presbyterian, New York, New York
| | | | - Dan Tong Jia
- Columbia University, College of Physician and Surgeons, New York, New York
| | - Paul M Armenta
- Columbia University, College of Physician and Surgeons, New York, New York
| | - Yichun Fu
- Columbia University, College of Physician and Surgeons, New York, New York
| | - Daisuke Izaki
- Columbia University, Columbia College, New York, New York
| | - Bret Taback
- Department of Surgery, Columbia University Medical Center/New York Presbyterian, New York, New York
| | - Raul Rabadan
- Department of Systems Biology, Columbia University, New York, New York
| | - Howard L Kaufman
- Department of Surgery, Rutgers Cancer Institute, New York, New York
| | - Charles G Drake
- Department of Medicine, Division of Hematology/Oncology, Columbia University Medical Center/New York Presbyterian, New York, New York
| | - Basil A Horst
- Department of Dermatopathology, Columbia University Medical Center, New York, New York
| | - Yvonne M Saenger
- Department of Medicine, Division of Hematology/Oncology, Columbia University Medical Center/New York Presbyterian, New York, New York.
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Pantaleão L, Rochael MC. Study of 448 cases of melanoma in situ in two hospitals in Rio de Janeiro. An Bras Dermatol 2017; 92:277-278. [PMID: 28538900 PMCID: PMC5429126 DOI: 10.1590/abd1806-4841.20175121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 02/19/2016] [Indexed: 11/21/2022] Open
Abstract
The diagnosis of cutaneous melanoma in situ, considered to have excellent
prognosis, has been increasingly frequent, with rare isolated reports of
cutaneous melanoma in situ presenting recurrence, metastasis, and death. No
specific study is found in the literature about these lesions of unexpected
behavior. We describe the demographic and histopathological findings of 448
cases of cutaneous melanoma in situ in 369 patients, emphasizing the prognostic
criteria of those with unfavorable outcomes, corresponding to 9 cases in which
regression had no significant role. Adnexotropism was found in 44.5% of cases.
The study of early lesions would allow clinicians to have a better understanding
of the evolutionary processes of the disease.
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Affiliation(s)
- Luciana Pantaleão
- Department of Pathology - Universidade Federal Fluminense (UFF) - Niterói (RJ), Brazil
| | - Mayra Carrijo Rochael
- Department of Pathology - Universidade Federal Fluminense (UFF) - Niterói (RJ), Brazil
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Biernacka A, Linos KD, DeLong PA, Suriawinata AA, Padmanabhan V, Liu X. A case of S-100 negative melanoma: A diagnostic pitfall in the workup of a poorly differentiated metastatic tumor of unknown origin. Cytojournal 2016; 13:21. [PMID: 27729935 PMCID: PMC5040106 DOI: 10.4103/1742-6413.190914] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 04/03/2016] [Indexed: 01/28/2023] Open
Abstract
When confronted with a metastatic poorly differentiated tumor of unknown origin, the initial workup includes the standard panel of immunostains to rule out carcinoma, sarcoma, lymphoma, and the greatest mimicker in pathology - malignant melanoma. Although not specific, the S-100 protein is expressed in over 95% of malignant melanomas. Herein, we present a case of multiorgan metastatic malignancy with a dominant hilar and mediastinal mass in a current smoker; clinically, highly suggestive of widespread primary lung cancer. This case was eventually classified as malignant melanoma, despite a significant diagnostic challenge due to lack of prior history, unusual cytomorphology, and S-100 protein negativity. A battery of immunostains was performed and the addition of other melanocytic-associated markers confirmed the melanocytic lineage of the neoplasm. This case highlights the pitfalls in the differential diagnosis of a metastatic tumor of unknown origin by fine needle aspiration cytology due to the significant morphologic overlap of poorly differentiated malignancies. We emphasize that, albeit rare, malignant melanomas can be completely negative for S-100 protein and the use of additional melanocytic-associated markers in the differential workup maybe critical in arriving promptly at a proper diagnosis. We also briefly discuss other currently available immunohistochemical markers that can assist in the identification of the S-100 negative melanoma.
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Affiliation(s)
- Anna Biernacka
- Address: Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon
| | - Konstantinos D Linos
- Address: Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon; Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Peter A DeLong
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA; Department of Pulmonary Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon
| | - Arief A Suriawinata
- Address: Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon; Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Vijayalakshmi Padmanabhan
- Address: Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon; Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Xiaoying Liu
- Address: Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon; Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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Sojka B, Podhorodecki A, Banski M, Misiewicz J, Drobczynski S, Dumych T, Lutsyk MM, Lutsyk A, Bilyy R. β-NaGdF4:Eu3+ nanocrystal markers for melanoma tumor imaging. RSC Adv 2016. [DOI: 10.1039/c6ra10351k] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Europium doped nanocrystals can be optimized to be successfully used as visualization markers for i.e. melanoma tumor.
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Affiliation(s)
- B. Sojka
- Department of Experimental Physics
- Wroclaw University of Technology
- Wroclaw
- Poland
| | - A. Podhorodecki
- Department of Experimental Physics
- Wroclaw University of Technology
- Wroclaw
- Poland
| | - M. Banski
- Department of Experimental Physics
- Wroclaw University of Technology
- Wroclaw
- Poland
| | - J. Misiewicz
- Department of Experimental Physics
- Wroclaw University of Technology
- Wroclaw
- Poland
| | - S. Drobczynski
- Department of Optics and Photonics
- Wroclaw University of Technology
- Wroclaw
- Poland
| | - T. Dumych
- Danylo Halytsky Lviv National Medical University
- Lviv
- Ukraine
| | - M. M. Lutsyk
- Danylo Halytsky Lviv National Medical University
- Lviv
- Ukraine
| | - A. Lutsyk
- Danylo Halytsky Lviv National Medical University
- Lviv
- Ukraine
| | - R. Bilyy
- Danylo Halytsky Lviv National Medical University
- Lviv
- Ukraine
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Bilyy R, Podhorodecki A. Can we use rare-earth nanocrystals to target glycans for the visualization of melanoma? Nanomedicine (Lond) 2015; 10:1997-2000. [DOI: 10.2217/nnm.15.78] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Rostyslav Bilyy
- Danylo Halytsky Lviv National Medical University, Pekarska Street 69, Lviv 79010, Ukraine
- Institute of Cell Biology NAS of Ukraine, Drahomanov Street 14/16, Lviv 79005, Ukraine
| | - Artur Podhorodecki
- Department of Experimental Physics, Wroclaw University of Technology, Wybrzeze Wyspianskiego 27, 50–370 Wroclaw, Poland
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Dumych T, Lutsyk M, Banski M, Yashchenko A, Sojka B, Horbay R, Lutsyk A, Stoika R, Misiewicz J, Podhorodecki A, Bilyy R. Visualization of melanoma tumor with lectin-conjugated rare-earth doped fluoride nanocrystals. Croat Med J 2014; 55:186-94. [PMID: 24891277 PMCID: PMC4049210 DOI: 10.3325/cmj.2014.55.186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 03/22/2014] [Indexed: 12/03/2022] Open
Abstract
AIM To develop specific fluorescent markers for melanoma tumor visualization, which would provide high selectivity and reversible binding pattern, by the use of carbohydrate-recognizing proteins, lectins, combined with the physical ability for imaging deep in the living tissues by utilizing red and near infrared fluorescent properties of specific rare-earth doped nanocrystals (NC). METHODS B10F16 melanoma cells were inoculated to C57BL/6 mice for inducing experimental melanoma tumor. Tumors were removed and analyzed by lectin-histochemistry using LABA, PFA, PNA, HPA, SNA, GNA, and NPL lectins and stained with hematoxylin and eosin. NPL lectin was conjugated to fluorescent NaGdF4:Eu(3+)-COOH nanoparticles (5 nm) via zero length cross-linking reaction, and the conjugates were purified from unbound substances and then used for further visualization of histological samples. Fluorescent microscopy was used to visualize NPL-NaGdF4:Eu(3+) with the fluorescent emission at 600-720 nm range. RESULTS NPL lectin selectively recognized regions of undifferentiated melanoblasts surrounding neoangiogenic foci inside melanoma tumor, PNA lectin recognized differentiated melanoblasts, and LCA and WGA were bound to tumor stroma regions. NPL-NaGdF4:Eu(3+) conjugated NC were efficiently detecting newly formed regions of melanoma tumor, confirmed by fluorescent microscopy in visible and near infrared mode. These conjugates possessed high photostability and were compatible with convenient xylene-based mounting systems and preserved intensive fluorescent signal at samples storage for at least 6 months. CONCLUSION NPL lectin-NaGdF4:Eu(3+) conjugated NC permitted distinct identification of contours of the melanoma tissue on histological sections using red excitation at 590-610 nm and near infrared emission of 700-720 nm. These data are of potential practical significance for development of glycans-conjugated nanoparticles to be used for in vivo visualization of melanoma tumor.
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Affiliation(s)
- Tetiana Dumych
- Institute of Cell Biology, National Academy of Sciences of Ukraine, Lviv, Ukraine
| | - Maxym Lutsyk
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Mateusz Banski
- Wroclaw University of Technology, Institute of Physics, Wroclaw, Poland
| | | | - Bartlomiej Sojka
- Wroclaw University of Technology, Institute of Physics, Wroclaw, Poland
| | - Rostyslav Horbay
- Institute of Cell Biology, National Academy of Sciences of Ukraine, Lviv, Ukraine
| | | | - Rostyslav Stoika
- Institute of Cell Biology, National Academy of Sciences of Ukraine, Lviv, Ukraine
| | - Jan Misiewicz
- Wroclaw University of Technology, Institute of Physics, Wroclaw, Poland
| | - Artur Podhorodecki
- Wroclaw University of Technology, Institute of Physics, Wroclaw, Poland
- Equally contributed as senior authors
| | - Rostyslav Bilyy
- Institute of Cell Biology, National Academy of Sciences of Ukraine, Lviv, Ukraine
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
- Equally contributed as senior authors
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Abstract
Although melanoma represents only 10% of all skin cancer diagnoses, it accounts for at least 65% of all skin cancer-related deaths. The number of new cutaneous melanoma cases projected during 2010 was 68,000-a 23% increase from the 2004 prediction of 55,100 cases. In 2015, the lifetime risk of developing melanoma is estimated to increase to 1 in 50. As the incidence of melanoma continues to rise, now more than ever, clinicians and histopathologists must have familiarity with the various clinical and pathologic features of cutaneous melanoma.
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Affiliation(s)
- Clay J Cockerell
- Department of Dermatology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
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Helm MF, Lin L. Calculating microscope field area is important for accurately determining melanoma mitotic rate. Dermatol Surg 2011; 37:1820-1. [PMID: 22182241 DOI: 10.1111/j.1524-4725.2011.02196.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Linos K, Slominski A, Ross JS, Carlson JA. Melanoma update: diagnostic and prognostic factors that can effectively shape and personalize management. Biomark Med 2011; 5:333-60. [PMID: 21657842 DOI: 10.2217/bmm.11.39] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Routine light microscopy remains a powerful tool to diagnose, stage and prognose melanoma. Although it is very economical and efficient, it requires a significant level of expertise and, in difficult cases the final diagnosis is affected by subjective interpretation. Fortunately, new insights into the genomic aberrations characteristic of melanoma, coupled with ancillary studies, are further refining evaluation and management allowing for more confident diagnosis, more accurate staging and the selection of targeted therapy. In this article, we review the standard of care and new updates including four probe FISH, the 2009 American Joint Commission on Cancer staging of melanoma and mutant testing of melanoma, which will be crucial for targeted therapy of metastatic melanoma.
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Gilaberte Y, Roca MJ, Garcia-Prats MD, Coscojuela C, Arbues MD, Vera-Alvarez JJ. Neuropeptide Y expression in cutaneous melanoma. J Am Acad Dermatol 2011; 66:e201-8. [PMID: 21620518 DOI: 10.1016/j.jaad.2011.02.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 12/25/2010] [Accepted: 02/15/2011] [Indexed: 01/26/2023]
Abstract
BACKGROUND Neuropeptide Y (NPY) is widely found in the nervous system and has a role in numerous physiologic processes. In addition, NPY receptors are expressed in neuroendocrine tumors, breast cancer, prostate cancer, kidney cancer, and some types of sarcomas. Different neuropeptides, particularly α-melanocyte-stimulating hormone (MSH), seem to play a role in the pathogenesis of melanoma. OBJECTIVE We sought to analyze the expression of NPY in cutaneous melanoma, its association with clinical and histologic features, and its correlation with α-MSH. METHODS This was an observational study of the immunohistochemical expression of NPY and α-MSH in tissue samples of cutaneous melanomas, different types of melanocytic nevi, and melanoma metastases diagnosed from 2004 to 2008 in San Jorge Hospital, Huesca, Spain. RESULTS A total of 184 lesions were studied: 49 primary cutaneous melanomas, 12 melanoma metastases (9 cutaneous and 3 lymphatic), and 123 melanocytic nevi. Immunostaining revealed that levels of NPY and α-MSH were significantly higher in melanomas than in melanocytic nevi (P < .001). Melanoma metastases were negative for both neuropeptides. Nodular melanomas showed the highest median percentage of NPY positive cells (75% [20-95]) followed by superficial spreading melanoma (25% [2-92]), whereas lentigo maligna were negative (0% [0-0]). Significant, direct associations between NPY expression and vertical growth (P = .0141) and presence of metastasis (P = .0196) were observed. NPY and α-MSH were positively correlated in cutaneous melanoma (0.49, P < .001). LIMITATIONS The sample size of melanomas was not very large. CONCLUSION Our study demonstrates that NPY is significantly expressed in melanomas, especially the nodular type, being associated with invasiveness independently of proliferative markers such as thickness, ulceration, and mitotic index.
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Piris A, Mihm MC, Duncan LM. AJCC melanoma staging update: impact on dermatopathology practice and patient management. J Cutan Pathol 2011; 38:394-400. [PMID: 21385199 DOI: 10.1111/j.1600-0560.2011.01699.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Changes in the 2010 American Joint Commission on Cancer melanoma staging guidelines include the evaluation of primary tumor mitotic index (mitogenicity) and the recognized prognostic significance of a single melanoma cell in a sentinel lymph node. These revised criteria have important practice implications for dermatopathologists as well as for dermatologists, oncologists and surgeons who treat patients with cutaneous melanoma.
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Affiliation(s)
- Adriano Piris
- Dermatopathology Unit, Pathology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
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