%0 Journal Article
%T RNA analysis of tape strips to rule out melanoma in lesions clinically assessed as cutaneous malignant melanoma: A diagnostic study.
%A Heerfordt IM
%A Philipsen PA
%A Andersen JD
%A Langhans L
%A Schmidt G
%A Morling N
%A Wulf HC
%J J Am Acad Dermatol
%V 89
%N 3
%D 2023 09 22
%M 37224970
%F 15.487
%R 10.1016/j.jaad.2023.05.030
%X Distinguishing cutaneous malignant melanoma (CMM) from nevi can be clinically challenging. Suspicious lesions are therefore excised, resulting in many benign lesions being removed surgically to find 1 CMM. It has been proposed to use tape strip derived ribonucleic acid (RNA) to distinguish CMM from nevi.<BR>To develop this technique further and validate if RNA profiles can rule out CMM in clinically suspicious lesions with 100% sensitivity.<BR>Before surgical excision, 200 lesions clinically assessed as CMM were tape stripped. Expression levels of 11 genes on the tapes were investigated by RNA measurement and used in a rule-out test.<BR>Histopathology showed that 73 CMMs and 127 non-CMMs were included. Our test correctly identified all CMMs (100% sensitivity) based on the expression levels of 2 oncogenes, PRAME and KIT, relative to a housekeeping gene. Patient age and sample storage time were also significant. Simultaneously, our test correctly excluded CMM in 32% of non-CMM lesions (32% specificity).<BR>Our sample contained a very high proportion of CMMs, perhaps due to inclusion during COVID-19 shutdown. Validation in a separate trial must be performed.<BR>Our results demonstrate that the technique can reduce removal of benign lesions by one-third without overlooking any CMMs.