Utilització de sondes fish per al diagnòstic de melanoma cutani a partir de casos reals

Abstract

This project is focused on studying the importance of FISH technique (Fluorescence In Situ Hybridization) for the diagnosis of cutaneous melanomas and the determination of ambiguous cases. The study begins with the complete protocol that is followed in the resolution of a complex case, since the sample arrives at the Pathological Anatomy Department of Hospital Clínic of Barcelona until the final report for the patient is concluded. This protocol deals with an initial microscopic study, an immunohistochemical analysis and, in case of a non-conclusive diagnosis, a FISH technique is implemented. Thus, the diagnostic criteria observable under the microscope that helps to differentiate malignant tumors from benign ones are exposed, emphasizing that it is not always possible to conclude this difference without the use of FISH. To analyze it, a study was carried out with 10 cases, of which 3 of them have been melanoma and the remainder have been benign. In almost all of them (with one exception) it has been essential to use the technique studied to solve them. Of these cases, there are some that have allowed us to demonstrate that histological and immunological studies are often inadequate to recognize the seriousness of the tumor and that, in these cases, the use of a technique such as FISH can be decisive for a correct diagnosis. Simultaneously to these cases, one geographic study has been carried out. It refers to the number of hospitals throughout Spain that use FISH to diagnose cutaneous melanomas. A bibliometric study has also been carried out and it includes a set of outstanding articles that focus on emphasizing the importance of this technique in this type of diagnosis. From these studies the year of publication has been valued with the intention of knowing the interest that FISH has aroused around the world and since when it began to be studied in depth. With this project it is possible to confirm the hypothesis of the relevance of the technique in this field and makes remarkable the lack of its use and study, in contrast to the positive results obtained