Document Detail

Expression of soluble adenylyl cyclase in lentigo maligna: use of immunohistochemistry with anti-soluble adenylyl cyclase antibody (R21) in diagnosis of lentigo maligna and assessment of margins.
MedLine Citation:
PMID:  23194049     Owner:  NLM     Status:  MEDLINE    
CONTEXT: Soluble adenylyl cyclase (sAC) is an enzyme that generates cyclic adenosine monophosphate, a signaling molecule involved in regulating melanocyte functions. R21, a mouse monoclonal antibody against sAC, shows a striking pan-nuclear staining in lentigo maligna, indicating possible utility for diagnosis and margin assessment.
OBJECTIVE: To evaluate R21 in the diagnosis and evaluation of margins in lentigo maligna.
DESIGN: Thirty one re-excision specimens for lentigo maligna were evaluated for R21 expression using previously published protocol. In addition, 153 cases including 41 lentigo malignas, 30 non-lentigo maligna-type melanomas, 38 lentigos, and 44 nevi were evaluated using a modified stringent protocol to eliminate all nonmelanocyte staining.
RESULTS: The sensitivity of nuclear staining with R21 in lentigo maligna was 87.8%. Nuclear expression of sAC was observed in 40% of other melanomas and 2.3% of benign nevi. R21 did not stain nuclei of resting melanocytes but was observed in 28.9% of melanocytic hyperplasias. These cases were easily distinguished from lentigo maligna in routine sections. R21 staining facilitated extent of the lesion in resection margins. In cases examined under the less stringent conditions, interpretation was facilitated by comparing R21 and Mart1/Melan A staining. Greater than 9 pan-nuclear staining melanocytes within one high-power field along with a pan-nuclear sAC/Melan A ratio greater than 0.5 was consistent with a positive margin whereas 5 or less pan-nuclear staining melanocytes along with a sAC/Melan A ratio of less than 0.3 constituted a negative margin.
CONCLUSION: R21 is a useful diagnostic adjunct in the diagnosis and evaluation of margins in re-excision specimens in lentigo maligna.
Cynthia M Magro; Sung-Eun Yang; Jonathan H Zippin; Artur Zembowicz
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  Archives of pathology & laboratory medicine     Volume:  136     ISSN:  1543-2165     ISO Abbreviation:  Arch. Pathol. Lab. Med.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-30     Completed Date:  2013-01-31     Revised Date:  2013-08-11    
Medline Journal Info:
Nlm Unique ID:  7607091     Medline TA:  Arch Pathol Lab Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1558-64     Citation Subset:  AIM; IM    
Department of Pathology, Weill Medical College of Cornell University, New York, New York, USA.
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MeSH Terms
Adenylate Cyclase / chemistry,  metabolism*
Antibodies, Monoclonal / metabolism*
Antibody Specificity
Cell Nucleus / enzymology,  metabolism,  pathology
Diagnosis, Differential
Gene Expression Regulation, Neoplastic
Hutchinson's Melanotic Freckle / diagnosis,  metabolism*,  pathology,  surgery
MART-1 Antigen / metabolism
Melanocytes / enzymology,  metabolism,  pathology
Melanoma / diagnosis,  metabolism,  pathology,  surgery
Neoplasm Proteins / chemistry,  metabolism*
Nevus / diagnosis,  metabolism,  pathology,  surgery
Sensitivity and Specificity
Skin / enzymology*,  metabolism,  pathology
Skin Neoplasms / diagnosis,  metabolism*,  pathology,  surgery
Tumor Markers, Biological / chemistry,  metabolism*
Grant Support
1 K08 CA 160657-01/CA/NCI NIH HHS; K08 CA160657/CA/NCI NIH HHS
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/MART-1 Antigen; 0/Neoplasm Proteins; 0/R21 monoclonal antibody; 0/Tumor Markers, Biological; EC Cyclase

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