Evaluation of Preferentially Expressed Antigen in Melanoma Expression and Epidemiologic Features in Dysplastic Nevi: A Comparative Analysis of Low- and High-Grade Lesions.
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INTRODUCTION: PReferentially expressed Antigen in Melanoma (PRAME) antibody is a crucial biomarker for differentiating melanoma from benign lesions. However, its diagnostic value in dysplastic nevi (DN) remains controversial. OBJECTIVES: This study investigates its diagnostic potential and clinicopathologic correlations. METHODS: PRAME was immunohistochemically assessed in 115 low-grade DN (LG-DN) and 18 high-grade DN (HG-DN). Staining was scored from 0 (no staining) to 4+ (75% or more). The relationship of PRAME expression with age, sex, location, and histologic grade was examined. RESULTS: We analyzed 133 DNs from 107 patients. Of these, 49.5% were female patients and 50.5% were male patients, with a mean age of 36.6 years (range 7-91). Female patients presented lesions at a younger age than male patients (31.7 vs. 40.6 years; P < 0.001). Histologic grade increased with age ( P = 0.017). Most lesions were located on the trunk (51.9% back, 27.1% chest) followed by the head and neck (7.5%). PRAME expression was score 0 in 84.3% of LG-DN and 77.8% of HG-DN. Score 4+ expression was observed in 7% of LG-DN and in 11.2% of HG-DN. Although a trend toward higher PRAME positivity in HG-DN was noted, it did not reach statistical significance. No correlations were found between PRAME expression and age, sex, location. CONCLUSIONS: The findings indicate that PRAME expression is not associated with histologic grade or clinical parameters in DN, suggesting that this marker may have limited prognostic or diagnostic value in these lesions. These results need to be supported by larger sample-sized and comparative studies.