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Updated: Jun 27, 2026
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A Robust Discovery Platform for the Identification of Novel Mediators of Melanoma Metastasis
Published on: March 8, 2022
PRAME Immunostaining in Acral Melanocytic Proliferations: A Meta-Analysis.
Ana L Toussaint1, Carlos Sánchez-Cárdenas2, Ruth Fuentes-García1
1School of Sciences, Universidad Nacional Autónoma de México, Mexico City, Mexico.
The American Journal of Dermatopathology
|June 26, 2026
Summary
PRAME immunohistochemistry aids in diagnosing acral melanoma, a rare skin cancer. This meta-analysis found PRAME expression has high accuracy, but definitive diagnosis still requires clinicopathologic assessment.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Acral cutaneous melanoma is an aggressive skin cancer on palms, soles, and nail units.
- PReferentially expressed Antigen in MElanoma (PRAME) is a marker highly expressed in melanomas.
- No prior meta-analysis focused on PRAME utility in acral melanocytic proliferations.
Purpose of the Study:
- To conduct the first meta-analysis on PRAME immunohistochemistry for diagnosing acral melanocytic proliferations.
- To objectively evaluate the diagnostic utility of PRAME in this specific subtype of melanoma.
Main Methods:
- Systematic review and meta-analysis of 13 studies involving 930 acral lesions (557 malignant, 373 benign).
- Utilized random-effects models to calculate diagnostic accuracy metrics (sensitivity, specificity, likelihood ratios).
- Assessed heterogeneity using Cochran Q and I2 statistics; generated summary receiver operating characteristic curves.
Main Results:
- PRAME expression demonstrated high diagnostic accuracy for acral melanoma at a cutoff of 3+/50%, with 78% sensitivity and 92% specificity.
- PRAME immunostaining improves diagnosis of acral melanocytic proliferations.
- Expression in atypical and borderline lesions showed variability and remains controversial.
Conclusions:
- PRAME immunohistochemistry is a valuable tool for enhancing the diagnosis of acral melanoma.
- Definitive diagnosis of acral melanoma necessitates comprehensive clinicopathologic evaluation, potentially including molecular correlation.
- Further research is needed to clarify PRAME's role in borderline and atypical acral melanocytic lesions.
