Original article
Development of a novel noninvasive adhesive patch test for the evaluation of pigmented lesions of the skin

https://doi.org/10.1016/j.jaad.2014.04.042Get rights and content
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open access

Background

The accurate clinical assessment of melanocytic neoplasms is a challenge for clinicians. Currently, obtaining a biopsy specimen and conducting a histologic examination is the standard of care. The incidence of melanoma in white populations is high, resulting in a large number of biopsy specimens.

Objective

The objective of this study is to develop a noninvasive genomic method using mRNA to classify pigmented skin lesions as either benign or malignant.

Methods

An adhesive patch method was used to obtain cells from the surface of melanocytic lesions. mRNA was extracted and a genomic signature was formulated in a training set of benign and malignant melanocytic neoplasms and subsequently tested in a validation set.

Results

A 2-gene signature assessing the expression levels of CMIP and LINC00518 was able to differentiate melanomas from nevi in an independent validation set of 42 melanomas and 22 nevi with a sensitivity of 97.6% and specificity of 72.7%.

Limitations

Larger and more diverse sets of melanomas and nevi are needed for additional validation of the molecular expression profiling in various subsets of melanocytic neoplasms.

Conclusion

Our data suggest that mRNA molecular signatures can serve as a highly useful noninvasive method of differentiating melanoma from nevi and decrease the number of unnecessary biopsies.

Key words

dysplastic nevi
melanocytic neoplasms
melanoma
molecular signatures
nevi

Abbreviations used

ACS
American Cancer Society
AUC
area under the curve
DTI
DermTech International
NF-κB
nuclear factor kappaB
NNT
number needed to treat
NPV
negative predictive value
PPV
positive predictive value
qRT-PCR
quantitative real-time polymerase chain reaction
ROC
receiver operator characteristic

Cited by (0)

Supported by DermTech International.

Dr Gerami has served as a consultant to and received honoraria from Abbott Molecular Labs, Myriad Genetics, Castle Biosciences Inc, DermTech International, and Neogenomics. Drs Alsobrook and Robin are consultants to DermTech International. Ms Palmer is an employee of DermTech International.