Imaging mass spectrometry assists in the classification of diagnostically challenging atypical Spitzoid neoplasms.

Lazova R, Seeley EH, Kutzner H, Scolyer RA, Scott G, Cerroni L, Fried I, Kozovska ME, Rosenberg AS, Prieto VG, Shehata BM, Durham MM, Henry G, Rodriguez-Peralto JL, Riveiro-Falkenbach E, Schaefer JT, Danialan R, Fraitag S, Vollenweider-Roten S, Sepehr A, Sangueza M, Hijazi N, Corredoira Y, Kowal R, Harris OM, Bravo F, Boyd AS, Gueorguieva R, Caprioli RM
J Am Acad Dermatol. 2016 75 (6): 1176-1186.e4

PMID: 27502312 · PMCID: PMC5112112 · DOI:10.1016/j.jaad.2016.07.007

BACKGROUND - Previously, using imaging mass spectrometry (IMS), we discovered proteomic differences between Spitz nevi and Spitzoid melanomas.

OBJECTIVE - We sought to determine whether IMS can assist in the classification of diagnostically challenging atypical Spitzoid neoplasms (ASN), to compare and correlate the IMS and histopathological diagnoses with clinical behavior.

METHODS - We conducted a retrospective collaborative study involving centers from 11 countries and 11 US institutions analyzing 102 ASNs by IMS. Patients were divided into clinical groups 1 to 4 representing best to worst clinical behavior. The association among IMS findings, histopathological diagnoses, and clinical groups was assessed.

RESULTS - There was a strong association between a diagnosis of Spitzoid melanoma by IMS and lesions categorized as clinical groups 2, 3, and 4 (recurrence of disease, metastases, or death) compared with clinical group 1 (no recurrence or metastasis beyond a sentinel node) (P < .0001). Older age and greater tumor thickness were strongly associated with poorer outcome (P = .01).

CONCLUSIONS - IMS diagnosis of ASN better predicted clinical outcome than histopathology. Diagnosis of Spitzoid melanoma by IMS was strongly associated with aggressive clinical behavior. IMS analysis using a proteomic signature may improve the diagnosis and prediction of outcome/risk stratification for patients with ASN.

Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

MeSH Terms (25)

Adolescent Adult Aged Aged, 80 and over Age Factors Child Child, Preschool Diagnosis, Differential Female Humans Lymphatic Metastasis Male Mass Spectrometry Melanoma Middle Aged Neoplasm Recurrence, Local Nevus, Epithelioid and Spindle Cell Proteins Retrospective Studies Risk Assessment Sentinel Lymph Node Biopsy Skin Neoplasms Treatment Outcome Tumor Burden Young Adult

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