TY - JOUR
T1 - Telomerase reverse transcriptase protein expression is more frequent in acral lentiginous melanoma than in other types of cutaneous melanoma
AU - Cho, Woo Cheal
AU - Wang, Wei Lien
AU - Milton, Denái R.
AU - Ingram, Davis R.
AU - Nagarajan, Priyadharsini
AU - Curry, Jonathan L.
AU - Ivan, Doina
AU - Lazar, Alexander J.
AU - Hwu, Wen-Jen
AU - Prieto, Victor G.
AU - Torres-Cabala, Carlos A.
AU - Aung, Phyu P.
N1 - Funding Information:
Aung was supported by Institutional Start-Up Funding and an Institutional Research Grant from The University of Texas MD Anderson Cancer Center, and a grant from the Melanoma Research Alliance.
Publisher Copyright:
© 2021 College of American Pathologists. All rights reserved.
PY - 2021/7
Y1 - 2021/7
N2 - Context.-Molecularly distinct from cutaneous melanomas arising from sun-exposed sites, acral lentiginous melanomas (ALMs) typically lack ultraviolet-signature mutations, such as telomerase reverse transcriptase (TERT) promoter mutations. Instead, ALMs show a high degree of copy number alterations, often with multiple amplifications of TERT, which are associated with adverse prognosis. The prognostic value of TERT protein expression in acral melanomas, however, is not established. Objective.-To evaluate the frequency and pattern of TERT immunoreactivity and assess the potential utility of TERT expression as a prognostic indicator in ALMs. Design.-TERT expression by immunohistochemistry was analyzed in a series of 57 acral and nonacral melanocytic lesions, including 24 primary and 6 metastatic ALMs. Clinical outcome in patients with ALMs by TERT expression was assessed. Results.-TERT expression was more frequent in ALMs than in nonlentiginous acral melanomas and nonacral cutaneous melanomas, and was absent in acral nevi (P ¼ .01). When present, TERT expression in ALMs was cytoplasmic and more intense than TERT expression in other melanocytic lesions (P ¼ .05) with a higher H-score (P ¼ .01). There was a trend toward decreased overall survival in patients with ALMs with TERT immunoreactivity, but it did not reach statistical significance. Furthermore, no correlation was found between TERT expression and disease-specific survival in patients with ALMs. Conclusions.-Although TERT protein expression was frequently detected in both primary and metastatic ALMs, TERT immunoreactivity in ALMs did not correlate with survival in our study. Further studies with larger cohorts are needed to elucidate the prognostic value of TERT expression in ALMs.
AB - Context.-Molecularly distinct from cutaneous melanomas arising from sun-exposed sites, acral lentiginous melanomas (ALMs) typically lack ultraviolet-signature mutations, such as telomerase reverse transcriptase (TERT) promoter mutations. Instead, ALMs show a high degree of copy number alterations, often with multiple amplifications of TERT, which are associated with adverse prognosis. The prognostic value of TERT protein expression in acral melanomas, however, is not established. Objective.-To evaluate the frequency and pattern of TERT immunoreactivity and assess the potential utility of TERT expression as a prognostic indicator in ALMs. Design.-TERT expression by immunohistochemistry was analyzed in a series of 57 acral and nonacral melanocytic lesions, including 24 primary and 6 metastatic ALMs. Clinical outcome in patients with ALMs by TERT expression was assessed. Results.-TERT expression was more frequent in ALMs than in nonlentiginous acral melanomas and nonacral cutaneous melanomas, and was absent in acral nevi (P ¼ .01). When present, TERT expression in ALMs was cytoplasmic and more intense than TERT expression in other melanocytic lesions (P ¼ .05) with a higher H-score (P ¼ .01). There was a trend toward decreased overall survival in patients with ALMs with TERT immunoreactivity, but it did not reach statistical significance. Furthermore, no correlation was found between TERT expression and disease-specific survival in patients with ALMs. Conclusions.-Although TERT protein expression was frequently detected in both primary and metastatic ALMs, TERT immunoreactivity in ALMs did not correlate with survival in our study. Further studies with larger cohorts are needed to elucidate the prognostic value of TERT expression in ALMs.
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U2 - 10.5858/arpa.2020-0330-OA
DO - 10.5858/arpa.2020-0330-OA
M3 - Article
C2 - 33053175
AN - SCOPUS:85108948820
SN - 0003-9985
VL - 145
SP - 842
EP - 850
JO - Archives of Pathology and Laboratory Medicine
JF - Archives of Pathology and Laboratory Medicine
IS - 7
ER -