Recommendation ID

Techniques for confirming a diagnosis in people with suspected atypical spitzoid melanocytic lesions:- In people with reported atypical spitzoid lesions, how effective are fluorescence in-situ hybridization (FISH), comparative genomic hybridization (CGH) and tests to detect driver mutations compared with histopathological examination alone in predicting disease-specific survival?
This should be investigated in a prospective diagnostic study. Secondary outcomes should include sensitivity, specificity, accuracy, positive predictive value, disease-specific survival and progression-free survival.

Any explanatory notes
(if applicable)

Why this is important:- Atypical spitzoid lesions continue to be diagnostically challenging. There are no reliably reproducible histological, immunohistochemistry or molecular features that allow exact typing and prognostic assessment of these lesions. The current 'gold standard' is histological examination with expert review, but it is not always possible to distinguish spitzoid melanoma from benign spitzoid melanocytic lesions.
Current molecular technologies such as FISH and CGH provide some help, but the results are difficult to interpret and may not be conclusive. Understanding and mapping changes in molecular pathways could predict outcome and inform individual treatment planning.

Source guidance details

Comes from guidance
Melanoma: assessment and management
Date issued
July 2015

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No