Boyle Jenny L, Haupt Helen M, Stern Jere B, Multhaupt Hinke A B
Department of Pathology, Pennsylvania Hospital, Philadelphia, PA 19107, USA.
Arch Pathol Lab Med. 2002 Jul;126(7):816-22. doi: 10.5858/2002-126-0816-TEIMMD.
Pathologists may encounter problems in the differential diagnosis of malignant melanoma, spindle and epithelioid neoplasms of peripheral nerves, and fibrohistiocytic tumors. Tyrosinase has been demonstrated to be a sensitive marker for melanoma.
To determine the specificity of tyrosinase expression in the differential diagnosis of melanoma, desmoplastic melanoma, and peripheral nerve sheath tumors.
Immunoreactivity for tyrosinase, HMB-45 (anti-gp100 protein), S100 protein, CD34, and vimentin was studied in 70 tumors, including 15 melanomas (5 desmoplastic, 4 amelanotic, 6 melanotic), 13 malignant peripheral nerve sheath tumors; 10 schwannomas (1 pigmented), 12 neurofibromas (4 pigmented), and 20 fibrohistiocytic tumors (10 dermatofibrosarcoma protuberans and 10 dermatofibromas). Microwave-based antigen retrieval was performed in 10mM citrate buffer, pH 6.0, for 20 minutes at 121 degrees C.
All melanomas demonstrated positive immunostaining for tyrosinase, HMB-45, and S100 protein. Immunoreactivity for HMB-45 was generally stronger than that for tyrosinase in amelanotic lesions and significantly stronger in 1 of the desmoplastic lesions. The 4 pigmented neurofibromas were focally positive for tyrosinase, but did not stain for HMB-45. The pigmented schwannoma was focally positive for both tyrosinase and HMB-45. The malignant peripheral nerve sheath tumors, dermatofibrosarcoma protuberans, and dermatofibromas were nonreactive for tyrosinase and HMB-45.
Our results support the sensitivity of tyrosinase expression and demonstrate the relative specificity of tyrosinase as a marker for melanocytic lesions, including desmoplastic melanoma, although pigmented peripheral nerve tumors may demonstrate focal positive staining. Immunoreactivity for tyrosinase and HMB-45 may have been enhanced by the microwave-based antigen-retrieval technique used in this study.
病理学家在恶性黑色素瘤、外周神经的梭形和上皮样肿瘤以及纤维组织细胞肿瘤的鉴别诊断中可能会遇到问题。酪氨酸酶已被证明是黑色素瘤的敏感标志物。
确定酪氨酸酶表达在黑色素瘤、促纤维增生性黑色素瘤和外周神经鞘瘤鉴别诊断中的特异性。
研究了70例肿瘤中酪氨酸酶、HMB-45(抗糖蛋白100蛋白)、S100蛋白、CD34和波形蛋白的免疫反应性,其中包括15例黑色素瘤(5例促纤维增生性、4例无色素性、6例有色素性)、13例恶性外周神经鞘瘤、10例神经鞘瘤(1例有色素)、12例神经纤维瘤(4例有色素)和20例纤维组织细胞肿瘤(10例隆突性皮肤纤维肉瘤和10例皮肤纤维瘤)。在pH值为6.0的10mM柠檬酸盐缓冲液中于121℃进行20分钟的基于微波的抗原修复。
所有黑色素瘤对酪氨酸酶、HMB-45和S100蛋白均呈阳性免疫染色。在无色素性病变中,HMB-45的免疫反应性通常强于酪氨酸酶,在1例促纤维增生性病变中显著更强。4例有色素的神经纤维瘤对酪氨酸酶呈局灶性阳性,但对HMB-45不染色。有色素的神经鞘瘤对酪氨酸酶和HMB-45均呈局灶性阳性。恶性外周神经鞘瘤、隆突性皮肤纤维肉瘤和皮肤纤维瘤对酪氨酸酶和HMB-45无反应。
我们的结果支持酪氨酸酶表达的敏感性,并证明酪氨酸酶作为黑素细胞病变标志物的相对特异性,包括促纤维增生性黑色素瘤,尽管有色素的外周神经肿瘤可能呈局灶性阳性染色。本研究中使用的基于微波的抗原修复技术可能增强了酪氨酸酶和HMB-45的免疫反应性。