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Author Notes:

Corresponding author: Rossitza Lazova, M.D., 15 York Street, P.O. Box 208059, New Haven, CT 06520-8059, Phone: 203 785-4094, Fax: 203 785-6869, rossitza.lazova@yale.edu.

Conflict of interest: The authors have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

The data has not been presented previously.

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Research Funding:

Funding: Supported in part by a grant: NIH/NIGMS 5P41 GM103391-05

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Dermatology
  • atypical Spitzoid neoplasm
  • histopathology
  • imaging mass spectrometry
  • mass spectrometry
  • Spitz nevus
  • Spitzoid melanoma
  • MELANOCYTIC NEOPLASMS
  • EXPERT PATHOLOGISTS
  • MALIGNANT MELANOMAS
  • LUNG-CANCER
  • NEVI
  • DIAGNOSIS
  • TUMORS
  • DISCORDANCE
  • SPECTRUM

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

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Journal Title:

Journal of The American Academy of Dermatology

Volume:

Volume 75, Number 6

Publisher:

, Pages 1176-+

Type of Work:

Article | Post-print: After Peer Review

Abstract:

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 information:

© 2016 American Academy of Dermatology, Inc.

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