Expression of p16 alone does not differentiate between Spitz nevi and Spitzoid melanoma
Ashley Mason
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
Search for more papers by this authorJade Wititsuwannakul
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
Search for more papers by this authorVincent R. Klump
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
Search for more papers by this authorJason Lott
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
Search for more papers by this authorCorresponding Author
Rossitza Lazova
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
Rossitza Lazova, MD
15 York Street, P.O. Box 208059, New Haven,
CT 06520-8059, USA
Tel: +1 203 785 4094
Fax: +1 203 785 6869
e-mail: [email protected]
Search for more papers by this authorAshley Mason
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
Search for more papers by this authorJade Wititsuwannakul
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
Search for more papers by this authorVincent R. Klump
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
Search for more papers by this authorJason Lott
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
Search for more papers by this authorCorresponding Author
Rossitza Lazova
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
Rossitza Lazova, MD
15 York Street, P.O. Box 208059, New Haven,
CT 06520-8059, USA
Tel: +1 203 785 4094
Fax: +1 203 785 6869
e-mail: [email protected]
Search for more papers by this authorAbstract
Background
Spitz nevi and Spitzoid melanomas show overlapping histopathologic features, often making the diagnosis challenging. The p16 protein functions as a tumor suppressor and loss of its expression may be seen in some melanomas.
Methods
We evaluated 18 Spitz nevi and 19 Spitzoid melanomas from the Yale Spitzoid Neoplasm Repository for p16 expression. A staining intensity score (SIS) was calculated by multiplying a score for the percentage of stained cells (0–3) by a score for staining intensity (0–3).
Results
Staining with p16 was positive in 15/18 (83%) Spitz nevi and 15/19 (79%) Spitzoid melanomas (p = 0.73). Both Spitz nevi and Spitzoid melanomas had a similar SISs, 4.9 and 3.8, respectively (p = 0.057). All 19 patients with Spitzoid melanomas had poor outcome with either death (6 patients) or metastases (13 patients) at a median (3 years) and mean (5.4 years) follow up. In contrast, all 18 patients with Spitz nevi had a benign course with no adverse events at a median (4 years) and mean (4 years) follow up.
Conclusions
We found no significant difference in p16 staining in Spitz nevi and Spitzoid melanomas. We conclude that p16 does not appear to be a useful immunohistochemical marker in distinguishing between Spitz nevi and Spitzoid melanomas.
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