# TERT Immunohistochemistry in Thin Melanomas Compared to Melanocytic Nevi

## TL;DR

This study compares TERT protein expression in thin melanomas and melanocytic nevi, finding significant differences but limited diagnostic usefulness.

## Contribution

The study provides new insights into TERT immunohistochemistry differences in thin melanomas versus nevi.

## Key findings

- TERT expression in thin melanomas was significantly higher in staining percentage, intensity, and localization compared to nevi.
- Most thin melanomas showed cytoplasmic staining in over 50% of cells and high staining intensity.
- Diagnostic accuracy of TERT immunohistochemistry was low, suggesting the need for additional markers.

## Abstract

Background/Objectives: Telomerase plays a vital role in preserving telomere length, a key process in cancer development. Human telomerase reverse transcriptase (hTERT) is commonly expressed in various cancers, including melanoma. This study evaluated hTERT protein expression in melanomas compared to melanocytic nevi. Methods: In total, we examined 75 melanocytic lesions using TERT immunohistochemistry on paraffin-embedded tissues; 36 of them were thin melanomas (Breslow index ≤ 1 mm) and 39 melanocytic nevi. Results: The TERT expression differed with statistical significance between the two studied groups, melanomas and melanocytic nevi, in all three aspects examined: percentage of staining (p = 0.006), intensity of staining (p = 0.035), and localisation of staining (p = 0.012). Three quarters of the melanomas stained in over 50% of the cells at cytoplasmic level, 52.78% of the melanomas exhibited an intensity of 3+, and all melanomas were stained at the cytoplasmic level, except for the two negative cases. The values were lower in the melanocytic nevi group. Still, the diagnostic values were relatively low (sensitivity = 75%, specificity = 58.97%, PPV = 62.79%, NPV = 71.88%, and ACC = 66.67%). Conclusions: TERT immunohistochemistry differed between the two studied groups; however, the diagnostic utility is low in our study. Combining with other immunohistochemical antibodies would probably increase the diagnostic power.