在黑色素瘤(PRAME)中优先表达抗原,癌症/睾丸抗原家族的成员,是皮肤癌诊断和治疗领域的核心。作为核受体和转录调节因子,PRAME在抑制视黄酸信号中起关键作用,这对细胞分化和增殖至关重要。其在各种恶性肿瘤中的异常过表达,特别是皮肤黑色素瘤,与更具侵袭性的肿瘤表型有关,将PRAME定位为诊断和预后标志物。在黑色素瘤中,PRAME通常高度表达,与其在良性痣中的弱表达或缺失相反,从而提高鉴别诊断的准确性。PRAME的诊断价值扩展到各种病变。它在葡萄膜黑色素瘤中显著表达,与转移风险增加有关。在肢端黑色素瘤中,尤其是那些组织病理学模糊的人,PRAME有助于提高诊断准确性。然而,其在皮囊样和指甲黑素细胞病变中的表达不一致,需要全面的方法进行准确评估。在软组织肉瘤中,PRAME可能特别有助于区分黑色素瘤和透明细胞肉瘤,一个重要的区别,由于它们相似的组织学外观,但不同的治疗方法和预后,或检测去分化和未分化的黑素瘤。在非黑色素瘤皮肤癌如基底细胞癌,鳞状细胞癌,和默克尔细胞癌,PRAME的可变表达可导致诊断复杂性。尽管面临这些挑战,PRAME作为黑色素瘤治疗靶点的潜力是显著的.新兴的免疫疗法,包括针对PRAME的T细胞疗法和疫苗,正在研究利用其癌症特异性表达。对PRAME在皮肤癌中的分子作用和作用机制的持续研究继续为诊断和治疗开辟新的途径。有可能改变黑色素瘤和相关皮肤癌的管理。
Preferentially Expressed Antigen in Melanoma (PRAME), a member of the cancer/testis antigen family, is central to the field of skin cancer diagnostics and therapeutics. As a nuclear receptor and transcriptional regulator, PRAME plays a critical role in inhibiting retinoic acid signalling, which is essential for cell differentiation and proliferation. Its aberrant overexpression in various malignancies, particularly cutaneous melanoma, is associated with more aggressive tumour phenotypes, positioning PRAME as both a diagnostic and prognostic marker. In melanoma, PRAME is typically highly expressed, in contrast to its weak or absent expression in benign nevi, thereby improving the accuracy of differential diagnoses. The diagnostic value of PRAME extends to various lesions. It is significantly expressed in uveal melanoma, correlating to an increased risk of metastasis. In acral melanomas, especially those with histopathological ambiguity, PRAME helps to improve diagnostic accuracy. However, its expression in spitzoid and ungual melanocytic lesions is inconsistent and requires a comprehensive approach for an accurate assessment. In soft tissue sarcomas, PRAME may be particularly helpful in differentiating melanoma from clear cell sarcoma, an important distinction due to their similar histological appearance but different treatment approaches and prognosis, or in detecting dedifferentiated and undifferentiated melanomas. In non-melanoma skin cancers such as basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma, the variable expression of PRAME can lead to diagnostic complexity. Despite these challenges, the potential of PRAME as a therapeutic target in melanoma is significant. Emerging immunotherapies, including T-cell-based therapies and vaccines targeting PRAME, are being investigated to exploit its cancer-specific expression. Ongoing research into the molecular role and mechanism of action of PRAME in skin cancer continues to open new avenues in both diagnostics and therapeutics, with the potential to transform the management of melanoma and related skin cancers.