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Original research
Analysis of PRAME immunocytochemistry in 109 acral malignant melanoma in situ
  1. Qiu-ju Miao1,
  2. Jie Zang1,
  3. Xue-Bao Shao1,
  4. Jian-fang Sun1,
  5. Yan-Ping Chen2,
  6. Hao Chen1
  1. 1Department of Pathology, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Dermatology, Nanjing, Jiangsu, China
  2. 2Department of Pathology, Fujian Medical University cancer Hospital, Fuzhou, Fujian, China
  1. Correspondence to Dr Hao Chen, Department of Pathology, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Dermatology, Nanjing, Jiangsu, China; ch76ch{at}163.com; Professor Yan-Ping Chen, Department of Pathology, Clinical Oncology School of Fujian Medical University and Fujian Cancer Hospital, Fuzhou, Fujian, China; kelf2006{at}126.com

Abstract

Aims Preferentially expressed antigen in melanoma (PRAME) recently is a reliable immunohistochemistry (IHC) marker for distinguishing melanoma from other lesions. However, there are few articles focused on PRAME use in acral malignant melanoma, the most common type in Asians. This study investigated PRAME IHC expression in a large series of acral malignant melanoma in situ to add to the body of clinical knowledge.

Methods PRAME IHC was performed in unequivocal cases of primary acral lentiginous melanoma in situ (ALMIS), subungual melanoma in situ (SMIS) and acral recurrent nevi as the control. PRAME tumour cell percentage positivity and intensity were expressed as categorised in a cumulative score by adding the quartile of positive tumour cells to intensity labelling. The final IHC expression was interpreted as negative (0–1), weak (2–3), moderate (4–5) or strong (6–7).

Results In 91 ALMIS patients, 32 cases (35.16%) were strong, 37 (40.66%) were moderate and 22 (24.18%) were weak. In 18 SMIS patients, strong positivity of PRAME was observed in 4 (22.22%) cases, moderate in 10 (55.56%) and weak in the remaining 4 (22.22%). No melanoma sample was negative for PRAME. By comparison, only 2 of the 40 acral recurrent nevi cases were positive.

Conclusions Our study supports the ancillary value of PRAME for diagnosing ALMIS and SMIS with high sensitivity and specificity.

  • IMMUNOCYTOCHEMISTRY
  • MELANOMA
  • DIAGNOSIS

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

https://doi.org/10.1136/jcp-2022-208697

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as online supplemental information.

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    Footnotes

    • Handling editor Vikram Deshpande.

    • Contributors The planning was guided by author Y-PC and HC. JZ and X-BS provided technical support. The interpretation and analysis of data was completed by QM and HC. The manuscript was written by QM, checked by JS and guaranted by HC.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.