The Self-Reported Use of Immunostains and Cytogenetic Testing in the Diagnosis of Melanoma by Practicing U.S. Pathologists of 10 Selected States.

Zhao G1, Lee KC2, Kwon G1, Frederick P3, Onega TL4, Piepkorn M1,5, Knezevich S6, Barnhill RL7, Elder D8, Elmore JG3.

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Abstract

BACKGROUND:

The diagnosis of melanoma can be challenging, especially in lesions for which the histopathologic criteria bridge two or more taxonomic categories. Newer genomic analytical methods of fluorescence in situ hybridization (FISH) and comparative genomic hybridization (CGH) have been introduced as ancillary techniques to differentiate benign and malignant melanocytic proliferations.

METHODS:

We evaluated how pathologists perceive and are incorporating these new cytogenetic testing technologies into their practices. We conducted a study of 207 U.S. pathologists who interpret melanocytic lesions in clinical practice in 10 SEER states. Pathologists were surveyed regarding perceptions and utilization of FISH and/or CGH in their clinical practices.

RESULTS:

Results showed that 38 percent of pathologists use FISH and/or CGH in interpreting melanocytic lesions. Pathologists reporting FISH and/or CGH use were significantly younger (p < 0.05), were fellowship trained or board certified in dermatopathology (p < 0.001), and were affiliated with an academic institute (p < 0.001). Pathologists reporting that their colleagues consider them an expert in the assessment of melanocytic lesions were more likely to employ FISH and/or CGH in their practices than non-experts.

CONCLUSIONS:

Early users of cytogenetic testing technologies in cutaneous pathology are more likely to be younger, affiliated with an academic institution, and fellowship trained or board certified in dermatopathology.