Fluorescence in situ hybridization (FISH) analysis of melanocytic nevi and melanomas: Sensitivity, specificity, and lack of association with sentinel node status Journal Article
| Authors: | Fang, Y.; Dusza, S.; Jhanwar, S.; Busam, K. J. |
| Article Title: | Fluorescence in situ hybridization (FISH) analysis of melanocytic nevi and melanomas: Sensitivity, specificity, and lack of association with sentinel node status |
| Abstract: | A 4-color fluorescence in situ hybridization (FISH) assay, using probes to chromosomes 11q, 6p, 6q, and 6 cent, has recently been proposed as an ancillary tool for the diagnosis of melanoma. The authors report herein their experience with this assay. To determine the sensitivity and specificity of the assay for histopathologically unequivocal cases, they analyzed 50 melanocytic nevi, 50 primary melanomas, and 15 metastatic melanomas. Of 50 melanocytic nevi, 47 were FISH negative on initial readout (test sensitivity, 94%); 49 were FISH negative after correction for tetraploidy (test specificity, 98%). Of 50 primary melanomas, 41 were FISH positive (test sensitivity, 82%). Of 15 metastatic lesions, 13 were FISH positive (test sensitivity, 85%). Of the 9 FISH-negative melanomas, 6 metastasized. The tumors of the 5 patients who had survived thick primary melanoma for more than 5 years without recurrence were all FISH positive. Half of the patients whose primary melanoma was tested by FISH had undergone sentinel lymph node (SLN) biopsy. When the authors compared the FISH results of those 25 melanomas with the SLN status, no statistically significant correlation was found. These findings document limitations of the current FISH assay. A rare nevus may be FISH positive. Some primary metastasizing melanomas are FISH negative. Even metastatic melanomas can be FISH negative. Awareness of the limitations in test sensitivity and specificity of the FISH assay is important to avoid an erroneous diagnosis by overreliance on cytogenetic findings. Correlation with clinical and histopathological findings is paramount for accurate diagnosis. © The Author(s) 2012. |
| Keywords: | adolescent; adult; cancer survival; child; human tissue; aged; aged, 80 and over; child, preschool; middle aged; primary tumor; young adult; major clinical study; histopathology; lymph nodes; lymphatic metastasis; diagnostic accuracy; sensitivity and specificity; sentinel lymph node biopsy; in situ hybridization, fluorescence; melanoma; metastasis; neoplasm recurrence, local; nevus; skin neoplasms; fluorescence in situ hybridization; melanocytic nevus; infant; nevus, pigmented; diagnostic errors; predictive value of tests; recurrent disease; chromosome aberrations; fish; chromosome analysis; chromosome 11q; chromosome 6q; diagnostic test accuracy study; chromosome 6p |
| Journal Title: | International Journal of Surgical Pathology |
| Volume: | 20 |
| Issue: | 5 |
| ISSN: | 1066-8969 |
| Publisher: | Sage Publications |
| Date Published: | 2012-10-01 |
| Start Page: | 434 |
| End Page: | 440 |
| Language: | English |
| DOI: | 10.1177/1066896912445923 |
| PROVIDER: | scopus |
| PUBMED: | 22561674 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 November 2012" - "CODEN: IJSPF" - "Source: Scopus" |
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