Journal
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
Volume 75, Issue 6, Pages 1176-+Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaad.2016.07.007
Keywords
atypical Spitzoid neoplasm; histopathology; imaging mass spectrometry; mass spectrometry; Spitz nevus; Spitzoid melanoma
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Funding
- National Institutes of Health/National Institute of General Medical Sciences NIH/NIGMS [5P41 GM103391-05]
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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.
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