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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 , . Journal of the American Academy of Dermatology. 2016 8 5; 75(6). 1176-1186.e4


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.