A Multicenter Study Validates the WHO 2022 Classification for Conjunctival Melanocytic Intraepithelial Lesions With Clinical and Prognostic Relevance.
Details
Serval ID
serval:BIB_EE8E58674D1F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A Multicenter Study Validates the WHO 2022 Classification for Conjunctival Melanocytic Intraepithelial Lesions With Clinical and Prognostic Relevance.
Journal
Laboratory investigation; a journal of technical methods and pathology
ISSN
1530-0307 (Electronic)
ISSN-L
0023-6837
Publication state
Published
Issued date
01/2024
Peer-reviewed
Oui
Volume
104
Number
1
Pages
100281
Language
english
Notes
Publication types: Review ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Several nomenclature and grading systems have been proposed for conjunctival melanocytic intraepithelial lesions (C-MIL). The fourth "WHO Classification of Eye Tumors" (WHO-EYE04) proposed a C-MIL classification, capturing the progression of noninvasive neoplastic melanocytes from low- to high-grade lesions, onto melanoma in situ (MIS), and then to invasive melanoma. This proposal was revised to the WHO-EYE05 C-MIL system, which simplified the high-grade C-MIL, whereby MIS was subsumed into high-grade C-MIL. Our aim was to validate the WHO-EYE05 C-MIL system using digitized images of C-MIL, stained with hematoxylin and eosin and immunohistochemistry. However, C-MIL cases were retrieved from 3 supraregional ocular pathology centers. Adequate conjunctival biopsies were stained with hematoxylin and eosin, Melan-A, SOX10, and PReferentially expressed Antigen in Melanoma. Digitized slides were uploaded on the SmartZoom platform and independently scored by 4 ocular pathologists to obtain a consensus score, before circulating to 14 expert eye pathologists for independent scoring. In total, 105 cases from 97 patients were evaluated. The initial consensus diagnoses using the WHO-EYE04 C-MIL system were as follows: 28 benign conjunctival melanoses, 13 low-grade C-MIL, 37 high-grade C-MIL, and 27 conjunctival MIS. Using this system resulted in 93% of the pathologists showing only fair-to-moderate agreement (kappa statistic) with the consensus score. The WHO-EYE05 C-MIL system (with high-grade C-MIL and MIS combined) improved consistency between pathologists, with the greatest level of agreement being seen with benign melanosis (74.5%) and high-grade C-MIL (85.4%). Lowest agreements remained between pathologists for low-grade C-MIL (38.7%). Regarding WHO-EYE05 C-MIL scoring and clinical outcomes, local recurrences of noninvasive lesions developed in 8% and 34% of the low- and high-grade cases. Invasive melanoma only occurred in 47% of the cases that were assessed as high-grade C-MIL. This extensive international collaborative study is the first to undertake a comprehensive review of the WHO-EYE05 C-MIL scoring system, which showed good interobserver agreement and reproducibility.
Keywords
Humans, Melanoma/diagnosis, Melanoma/pathology, Prognosis, Reproducibility of Results, Eosine Yellowish-(YS), Hematoxylin, Melanocytes, Skin Neoplasms/pathology, Melanosis/pathology, World Health Organization, Multicenter Studies as Topic, conjunctival melanoma, conjunctival melanoma in situ, digital pathology, high-grade conjunctival melanocytic intraepithelial lesions, immunohistochemistry, low-grade conjunctival melanocytic intraepithelial lesions
Pubmed
Web of science
Open Access
Yes
Create date
10/11/2023 12:20
Last modification date
30/01/2024 8:34