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Goldstein AM, Qin R, Chu EY, Elder DE, Massi D, Adams DJ, Harms PW, Robles-Espinoza CD, Newton-Bishop JA, Bishop DT, Harland M, Holland EA, Cust AE, Schmid H, Mann GJ, Puig S, Potrony M, Alos L, Nagore E, Millán-Esteban D, Hayward NK, Broit N, Palmer JM, Nathan V, Berry EG, Astiazaran-Symonds E, Yang XR, Tucker MA, Landi MT, Pfeiffer RM, Sargen MR. Association of germline variants in telomere maintenance genes ( POT1, TERF2IP, ACD, and TERT) with spitzoid morphology in familial melanoma: A multi-center case series. JAAD Int 2023; 11:43-51. [PMID: 36876055 PMCID: PMC9978843 DOI: 10.1016/j.jdin.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 01/31/2023] Open
Abstract
Background Spitzoid morphology in familial melanoma has been associated with germline variants in POT1, a telomere maintenance gene (TMG), suggesting a link between telomere biology and spitzoid differentiation. Objective To assess if familial melanoma cases associated with germline variants in TMG (POT1, ACD, TERF2IP, and TERT) commonly exhibit spitzoid morphology. Methods In this case series, melanomas were classified as having spitzoid morphology if at least 3 of 4 dermatopathologists reported this finding in ≥25% of tumor cells. Logistic regression was used to calculate odds ratios (OR) of spitzoid morphology compared to familial melanomas from unmatched noncarriers that were previously reviewed by a National Cancer Institute dermatopathologist. Results Spitzoid morphology was observed in 77% (23 of 30), 75% (3 of 4), 50% (2 of 4), and 50% (1 of 2) of melanomas from individuals with germline variants in POT1, TERF2IP, ACD, and TERT, respectively. Compared to noncarriers (n = 139 melanomas), POT1 carriers (OR = 225.1, 95% confidence interval: 51.7-980.5; P < .001) and individuals with TERF2IP, ACD, and TERT variants (OR = 82.4, 95% confidence interval: 21.3-494.6; P < .001) had increased odds of spitzoid morphology. Limitations Findings may not be generalizable to nonfamilial melanoma cases. Conclusion Spitzoid morphology in familial melanoma could suggest germline alteration of TMG.
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Affiliation(s)
- Alisa M. Goldstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Richard Qin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Emily Y. Chu
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - David E. Elder
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daniela Massi
- Section of Pathological Anatomy, Department of Health Sciences, University of Florence, Florence, Italy
| | - David J. Adams
- Experimental Cancer Genetics, The Wellcome Trust Sanger Institute, Hinxton, England
| | - Paul W. Harms
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Carla Daniela Robles-Espinoza
- Experimental Cancer Genetics, The Wellcome Trust Sanger Institute, Hinxton, England
- Laboratorio Internacional de Investigación sobre el Genoma Humano, Universidad Nacional Autónoma de México, Campus Juriquilla, Santiago de Querétaro, Qro, Mexico
| | - Julia A. Newton-Bishop
- Division of Haematology and Immunology, Institute of Medical Research at St James’s, University of Leeds, Leeds, England
| | - D. Timothy Bishop
- Division of Haematology and Immunology, Institute of Medical Research at St James’s, University of Leeds, Leeds, England
| | - Mark Harland
- Division of Haematology and Immunology, Institute of Medical Research at St James’s, University of Leeds, Leeds, England
| | - Elizabeth A. Holland
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council, NSW, Sydney, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
| | - Anne E. Cust
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council, NSW, Sydney, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Helen Schmid
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council, NSW, Sydney, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Graham J. Mann
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
- John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - Susana Puig
- Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, IDIBAPS, Barcelona University, Barcelona, Spain
- Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - Miriam Potrony
- Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
- Melanoma Unit, Biochemistry and Molecular Genetics Department, Hospital Clínic de Barcelona, IDIBAPS, Barcelona University, Barcelona, Spain
| | - Llucia Alos
- Pathology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Eduardo Nagore
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, València, Spain
- School of Medicine, Universidad Católica de València San Vicente Mártir, València, Spain
| | - David Millán-Esteban
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, València, Spain
- School of Medicine, Universidad Católica de València San Vicente Mártir, València, Spain
| | | | - Natasa Broit
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Jane M. Palmer
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Vaishnavi Nathan
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Elizabeth G. Berry
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | | | - Xiaohong R. Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Margaret A. Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Ruth M. Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Michael R. Sargen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
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