MELANOSİTİK LEZYONLARDA FLORESAN İN-SİTU HİBRİDİZASYON (FISH) YÖNTEMİNİN KULLANIMI

Dermatopatoloji pratiğinin önemli bir bölümünü oluşturan melanositik proliferasyonlar banal nevüsten melanoma kadar değişen geniş bir lezyon grubunu kapsamaktadır. Bu lezyonların bir kısmında benign ve malign ayrımı histopatolojik bulgular ile kolayca yapılırken, bir grup lezyonda ise net histopatolojik tanı verilememektedir. Son zamanlarda, bu grubu oluşturan lezyonların ayırıcı tanısında ve klinik davranışının tahmininde yardımcı bir moleküler test olarak floresan in-situ hibridizasyon (FISH) yönteminin kullanımı ile ilgili çok sayıda çalışma yayınlanmıştır. Özellikle geniş bir prob setini (6p25, 6q23, 8q24, 9p21, 11q13) içeren FISH testi kullanımının yüksek oranda duyarlılık ve özgüllük ile ayırıcı tanıda yardımcı olabileceği ve FISH testi sonuçlarının prognoz hakkında bilgi verebileceğine dair sonuçlar elde edilmiştir. Ancak, yanlış negatif ve yanlış pozitif FISH sonuçları göz önünde bulundurularak sonuçların mutlaka histopatolojik bulgular eşliğinde değerlendirilmesi gerektiği vurgulanmaktadır. Bu derlemede, FISH yöntemini farklı melanositik lezyon alt gruplarında, farklı kriterler ile değerlendiren çalışmalar özetlenecektir.

Anahtar Kelimeler:

Floresan in-situ hibridizasyon, FISH, melanom, melanositik lezyonlar

USE OF FLUORESCENCE IN-SITU HYBRIDIZATION (FISH) IN MELANOCYTIC LESIONS

The melanocytic proliferations including a wide of various lesions from melanocytic nevi to melanoma comprise one of the major groups of daily dermatopathology pratic. While a part of these lesions can be easily distinguished whether they are benign or malign, a group of lesions cannot be diagnosed exactly with only histopathologic features. In recent years, many research has been published about using of fluorescence in-situ hybridization (FISH) for differential diagnosis and to predict the clinical behaviour of these ambiguous lesions. The results have been showed that using of FISH test including a prob set (6p25, 6q23, 8q24, 9p21, 11q13) can be an ancillary molecular test to diagnose with high sensitivity and specificity, and the FISH results can provide prognostic information. However, FISH results should be evaluated with histopathologic findings due to high rates of false negativity or false positivity of the test. In the current review, the research investigating FISH method in different melanocytic lesion subgroups with different evaluation criteria will be summarized.

Keywords:

Fluorescence in-situ hybridization, FISH, melanoma, melanocytic lesions,

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