Comparison of MART-1 Frozen Sections to Permanent Sections Using a Rapid 19-Minute Protocol

Abstract

The use of melanoma-associated antigen recognized by T cells (MART-1) immunostain has been proposed as a useful adjunct to overcome the inherent difficulties in the use of frozen sections during Mohs surgery for the treatment of melanoma, but no studies have compared MART-1 frozen sections with MART-1 permanent sections. Current MART-1 1-hour protocols add significant time to the procedure. To determine whether there is a significant difference between frozen and permanent MART-1 immunostained sections using a rapid 19-minute protocol. Frozen and permanent sections stained with MART-1 were made from dog-ears excised during 25 reconstructions. A rapid 19-minute protocol was used to stain the frozen tissue. The sections were examined blinded, and statistical analysis was performed to analyze the data. No significant difference was found in number of keratinocytes, nuclear diameter of keratinocytes, number of melanocytes, melanocytic nuclear diameter, confluence, pagetoid spread, melanocytic nesting, or atypical melanocytes. The 19-minute protocol is a rapid and effective MART-1 immunostain. Frozen sections stained with MART-1 provide information equivalent to that obtained from MART-1 stained permanent sections. Mohs surgeons using MART-1 can feel confident that they have the same information as they would have obtained using permanent sections using the slow Mohs method.