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Background Histopathologic examination is sometimes inadequate for accurate and reproducible diagnosis of certain melanocytic neoplasms. As a result, more sophisticated and objective methods have been sought. The goal of this study was to identify a gene expression signature that reliably differentiated benign and malignant melanocytic lesions and evaluate its potential clinical applicability. Herein, we describe the development of a gene expression signature and its clinical validation using multiple independent cohorts of melanocytic lesions representing a broad spectrum of histopathologic subtypes. Methods Using quantitative reverse‐transcription polymerase chain reaction ( PCR ) on a selected set of 23 differentially expressed genes, and by applying a threshold value and weighting algorithm, we developed a gene expression signature that produced a score that differentiated benign nevi from malignant melanomas. Results The gene expression signature classified melanocytic lesions as benign or malignant with a sensitivity of 89% and a specificity of 93% in a training cohort of 464 samples. The signature was validated in an independent clinical cohort of 437 samples, with a sensitivity of 90% and specificity of 91%. Conclusions The performance, objectivity, reliability and minimal tissue requirements of this test suggest that it could have clinical application as an adjunct to histopathology in the diagnosis of melanocytic neoplasms.

Disruption of the nucleotide excision repair (NER) pathway by mutations can cause xeroderma pigmentosum, a syndrome predisposing affected individuals to development of skin cancer. The xeroderma pigmentosum C (XPC) protein is essential for initiating global genome NER by recognizing the DNA lesion and recruiting downstream factors. Here we show that inhibition of the deacetylase and longevity factor SIRT1 impairs global genome NER through suppressing the transcription of XPC in a SIRT1 deacetylase-dependent manner. SIRT1 enhances XPC expression by reducing AKTdependent nuclear localization of the transcription repressor of XPC. Finally, we show that SIRT1 levels are significantly reduced in human skin tumors from Caucasian patients, a population at highest risk. These findings suggest that SIRT1 acts as a tumor suppressor through its role in DNA repair.ucleotide excision repair (NER) is a versatile DNA repair pathway that eliminates a wide variety of helix-distorting base lesions, including UV radiation-induced cyclobutane pyrimidine dimers (CPD) and (6-4) photoproducts (6-4PPs) (1, 2), as well as bulky adducts induced by numerous chemical compounds. Defects in NER by mutations cause the autosomal recessive xeroderma pigmentosum (XP) and Cockayne syndromes (3-5). XP patients are clinically characterized by cutaneous sensitivity to sunlight exposure and a predisposition to skin cancer. Seven NER-deficient genetic complementation groups of XP (XP-A to -G) have been identified, and all of the corresponding genes have now been cloned (3-5).Mammalian NER consists of two distinct subpathways: global genome NER (GG-NER), which operates throughout the genome, and transcription-coupled NER (TC-NER), which specifically removes lesions on the transcribed DNA strand of active genes. A major difference between these two pathways appears to lie in the strategies for detecting damaged bases. Accumulating evidence indicates that the XP group C (XPC) protein plays an essential role in GG-NER-specific damage recognition (6-8). Although biochemical and genetic analyses have characterized the function of XPC in considerable detail, much remains to be elucidated with regard to its regulation and interaction with other critical cellular pathways.Sirtuin 1 (SIRT1), a mammalian counterpart of the yeast silent information regulator 2 (Sir2) and a proto member of the sirtuin family, is an NAD-dependent longevity-promoting deacetylase. SIRT1 is crucial for cell survival, metabolism, senescence, and stress response in several cell types and tissues (9-13). Both histone and nonhistone targets of SIRT1 have been identified, including FOXO, p53, and PPARγ (10,12,14). SIRT1 has been implicated as an important player in cancer. However, it remains unclear whether SIRT1 serves as a tumor suppressor or a tumor promoter (13-16). SIRT1 expression is relatively higher in many malignancies, including colon, breast, prostate, and skin cancers and leukemia, as compared with their corresponding normal tissues (17)(18)(19)(20)(21)(22). But the specific c...

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