The University of Florida Dermatopathology Experience With the Pigmented Lesion Assay

The pigmented lesion assay (PLA) is a noninvasive test used to risk stratify pigmented lesions and rule out melanoma. There is a scarcity of data from nonbiased studies on PLA performance in the real world. PLA results from 107 skin specimens were compared with final pathologic diagnoses. To determine clinical relevance of PLA results, diagnoses were categorized into actionable melanocytic, nonactionable melanocytic, and nonmelanocytic. Of specimens with positive PLA results, 24.0% (25/104) were actionable melanocytic diagnoses, 42.3% (44/104) nonactionable melanocytic, and 33.7% (35/104) nonmelanocytic. Because most specimens submitted for pathologic evaluation had positive PLA results, positive predictive values were calculated for overall PLA results and the individual genes tested. The overall positive predictive value for surgically actionable melanocytic lesions was 24.0%. The positive predictive values of the individual genes were determined to be 28.2% for LINC00518, 34.7% for PReferentially expressed Antigen in Melanoma, and 31.8% for telomerase reverse transcriptase.