title: Differentiation of malignant melanoma from benign nevus using a novel genomic microarray with low specimen requirements.
abstract: BACKGROUND
  Histologic examination of clinically suspicious melanocytic lesions is very sensitive and specific for the detection of malignant melanoma. Yet, the malignant potential of a small percentage of melanocytic lesions remains histologically uncertain. Molecular testing offers the potential to detect the genetic alterations that lead to malignant behavior without overt histologic evidence of malignancy.
  
  
  OBJECTIVE
  To differentiate benign melanocytic nevi from malignant melanoma and to predict the clinical course of melanocytic lesions with ambiguous histology using a novel genomic microarray.
  
  
  METHODS
  We applied a newly developed single-nucleotide polymorphism genomic microarray to formalin-fixed, paraffin-embedded melanocytic lesions to differentiate benign nevi (n  =  23) from malignant melanoma (n  =  30) and to predict the clinical course of a set of histologically ambiguous melanocytic lesions (n  =  11).
  
  
  RESULTS
  For cases with unambiguous histology, there was excellent sensitivity and specificity for identifying malignant melanoma with this genomic microarray (89% sensitivity, 100% specificity). For cases with ambiguous histology, the performance of this genomic microarray was less impressive.
  
  
  CONCLUSIONS
  Without microdissection and with quantities of DNA one-tenth what is required for more commonly used microarrays, this microarray can differentiate between malignant melanoma and benign melanocytic nevi. For histologically ambiguous lesions, longer clinical follow-up is needed to confidently determine the sensitivity and specificity of this microarray. Some of the previous technical hurdles to the clinical application of genomic microarray technology are being overcome, and the advantages over targeted fluorescence in situ hybridization assays currently in clinical use are becoming apparent.
authors: Department of Dermatopathology, Dominion Pathology Laboratories, Norfolk, VA 23510, USA. wellsmchandler@gmail.com
authors: Wells M
authors: WM
authors: Chandler
authors: Leslie R
authors: LR
authors: Rowe
authors: Scott R
authors: SR
authors: Florell
authors: Mona S
authors: MS
authors: Jahromi
authors: Joshua D
authors: JD
authors: Schiffman
authors: Sarah T
authors: ST
authors: South
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D004273:DNA, Neoplasm / Q000235:genetics / Q000302:isolation & purification / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D055106:Genome-Wide Association Study; D006801:Humans; D007223:Infant; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D025202:Molecular Diagnostic Techniques; D009506:Nevus / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D020411:Oligonucleotide Array Sequence Analysis; D012680:Sensitivity and Specificity; D012867:Skin / Q000378:metabolism / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism* / Q000473:pathology
chemical_list: D004273:DNA, Neoplasm