FISH May Indicate Prognosis of Atypical Spitzoid Tumors

More studies needed to verify value of fluorescence in situ hybridization

THURSDAY, May 5 (HealthDay News) -- Fluorescence in situ hybridization (FISH) analysis may improve the prognostic evaluation of atypical Spitzoid tumors, according to a study published in the May issue of the Journal of the American Academy of Dermatology.

Daniela Massi, M.D., from the University of Florence in Italy, and colleagues evaluated whether the presence of chromosomal abnormalities could assist with diagnostic and prognostic assessment of atypical Spitzoid lesions with a thickness of 1 mm or more. The clinicopathological features of 38 patients were analyzed, and chromosomal abnormalities were identified by FISH analysis in 25 patients. The mutational status of BRAFV600E and H-RAS genes was assessed by allele-specific real-time polymerase chain reaction and direct sequencing, respectively.

The investigators identified micrometastases in four of the nine patients who underwent sentinel lymph node biopsy. In those who did not undergo biopsy, four had bulky lymph node metastases and one experienced visceral metastases and death. Patients with lymph node involvement showed significantly more deep mitoses, less inflammation, and more plasma cells in Spitzoid lesions. Chromosomal alterations were detected by FISH analysis in six patients. Follow-up data from the FISH analysis indicated that the only fatal outcome exhibited multiple chromosomal alterations. BRAFV600E mutation was detected in 75 percent of cases and H-RAS mutation on exon 3 was detected in 27 percent of cases.

"In the context of ambiguous and diagnostically controversial Spitzoid proliferations, after a careful histologic evaluation, FISH analysis may be of help for diagnosis and prognosis," the authors write. "Our results are preliminary, and clearly deserve validation in a larger series with long-term follow-up information."

The study was partially funded by Abbott Molecular Inc.

Abstract
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