Article ; Online: Immunohistochemistry utilization in the diagnosis of melanoma.
Journal of cutaneous pathology
2020 Volume 47, Issue 5, Page(s) 446–450
Abstract: Background: The use of immunohistochemical (IHC) stains in dermatopathology is commonplace; however, little is known regarding utilization trends in melanoma diagnosis. Current Medicare local coverage determinations (LCDs) state that most pigmented ... ...
Abstract | Background: The use of immunohistochemical (IHC) stains in dermatopathology is commonplace; however, little is known regarding utilization trends in melanoma diagnosis. Current Medicare local coverage determinations (LCDs) state that most pigmented lesions, including melanoma, can be diagnosed using H&E alone. Methods: Histopathology reports for all biopsy-proven melanomas excised between January 1, 2017 and June 30, 2018, at a single dermatology clinic, were identified with the following parameters abstracted: laboratory/dermatopathologist rendering the diagnosis, whether IHC was performed, type/number of stains utilized, presence/depth of invasion, and melanoma subtype. The association of characteristics with IHC utilization was evaluated using χ Results: Three hundred and fifty six eligible melanomas were identified. IHC was employed in 228 (64%) of the diagnoses. Invasive melanoma was diagnosed in 199 cases (55.9%) while 157 (44.1%) were identified as melanoma in situ (MIS). Of the 228 that utilized IHC, 117 were performed on invasive melanoma (58.8%) and 111 were performed on MIS (70.7%). Conclusion: Our findings suggest a higher IHC usage for the diagnosis of melanoma than previously reported. Existing LCDs regarding IHC utilization in melanoma do not reflect the current state of practice. Further investigation regarding IHC utilization and the development of appropriate-use criteria for melanoma IHC is necessary. |
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MeSH term(s) | Biopsy ; Female ; Humans ; Immunohistochemistry/methods ; Immunohistochemistry/statistics & numerical data ; MART-1 Antigen/metabolism ; Male ; Medicare/standards ; Medicare/statistics & numerical data ; Melanoma/diagnosis ; Melanoma/metabolism ; Melanoma/pathology ; Neoplasm Invasiveness/pathology ; Nevus, Pigmented/pathology ; Retrospective Studies ; SOXE Transcription Factors/metabolism ; Skin Neoplasms/pathology ; United States/epidemiology |
Chemical Substances | MART-1 Antigen ; SOX10 protein, human ; SOXE Transcription Factors |
Language | English |
Publishing date | 2020-01-27 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 187078-6 |
ISSN | 1600-0560 ; 0303-6987 |
ISSN (online) | 1600-0560 |
ISSN | 0303-6987 |
DOI | 10.1111/cup.13648 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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