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TERT and TERT promoter in melanocytic neoplasms: Current concepts in pathogenesis, diagnosis, and prognosis
Author(s) -
Motaparthi Kiran,
Kim Jinah,
Andea Aleodor A.,
Missall Tricia A.,
Novoa Roberto A.,
Vidal Claudia I.,
Fung Maxwell A.,
Emanuel Patrick O.
Publication year - 2020
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.13691
Subject(s) - melanoma , pathogenesis , telomerase , melanocytic nevus , cancer research , carcinogenesis , medicine , telomerase reverse transcriptase , telomere , nevus , cancer , pathology , biology , gene , genetics
Background and objective Located on chromosome locus 5p15.33, telomerase reverse transcriptase ( TERT or h TERT ) encodes the catalytic subunit of telomerase which permits lengthening and preservation of telomeres following mitosis. Mutations in TERT promoter ( TERT ‐p) upregulate expression of TERT , allowing survival of malignant cells and tumor progression in wide variety of malignancies including melanoma. The objective of this review is to examine the roles of TERT and TERT‐p in the pathogenesis, diagnosis, and prognostication of cutaneous melanoma. Methods All studies of TERT or TERT‐p in cutaneous melanocytic neoplasms with the following inclusion criteria were reviewed: publication date between 2010 and 2019, English language, and series of ≥3 cases were reviewed for evidence supporting the role of TERT in pathogenesis, diagnosis, and prognosis. Studies with <3 cases or focused primarily on mucosal or uveal melanocytic tumors were excluded. Results and conclusion TERT ‐p mutations are frequent in chronic and non‐chronic sun damage melanoma and correlate with adverse prognosis, inform pathogenesis, and may provide diagnostic support. While TERT ‐p mutations are uncommon in acral melanoma, TERT copy number gains and gene amplification predict reduced survival. Among atypical spitzoid neoplasms, TERT ‐p mutations identify biologically aggressive tumors and support the diagnosis of spitzoid melanoma. TERT ‐p methylation may have prognostic value in pediatric conventional melanoma and drive tumorigenesis in melanoma arising within congenital nevi. Finally, TERT ‐p mutations may aid in the differentiation of recurrent nevi from recurrent melanoma.