Patel Rajiv M, Goldblum John R, Hsi Eric D
Division of Pathology and Laboratory Medicine, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Mod Pathol. 2004 Apr;17(4):456-60. doi: 10.1038/modpathol.3800061.
Kaposi sarcoma is a low-grade vascular neoplasm that has been shown by molecular analysis to uniformly express the latent nuclear antigen-1 of human herpes virus 8. Differentiating Kaposi sarcoma from other benign or malignant vascular tumors, as well as other nonvascular spindle cell soft-tissue neoplasms, can be challenging. Thus, detection of human herpes virus 8 in fixed tissues would be diagnostically useful. Recently, a monoclonal antibody to human herpes virus 8 latent nuclear antigen-1 has become commercially available for immunohistochemical analysis. We sought to study the sensitivity and specificity of this antibody in the detection of human herpes virus 8 latent nuclear antigen-1 in Kaposi sarcoma. Fixed, paraffin-embedded tissue sections from 21 cases of Kaposi sarcoma, nine cases of spindle cell hemangioma, five cases of cutaneous angiosarcoma, five cases of dermatofibrosarcoma protuberans, one case of vascular transformation of a lymph node, four cases of pilar leiomyoma, four cases of stasis dermatitis, four cases of pyogenic granuloma, and three cases of spindled melanoma were examined immunohistochemically using the rat monoclonal antibody to human herpes virus 8 latent nuclear antigen-1, open reading frame-73 (Advanced Biotechnologies Inc.). Tissue sections were stained with automated immunostainers (Ventana) using heat-induced epitope retrieval and a standard DAB detection kit (Ventana) modified to detect rat Ab. Strong, diffuse, nuclear staining in >10% of tumor cells was considered a positive result. In all, 21/21 cases of Kaposi sarcoma showed strong, diffuse, nuclear staining for human herpes virus 8 latent nuclear antigen-1 (100%), whereas all cases of spindle cell hemangioma, cutaneous angiosarcoma, dermatofibrosarcoma protuberans, vascular transformation of lymph node, pilar leiomyoma, stasis dermatitis, pyogenic granuloma, and spindled melanoma were negative for this antigen. The monoclonal antibody to human herpes virus 8 latent nuclear antigen-1, open reading frame-73, is a highly sensitive and specific marker of human herpes virus 8 infection in paraffin-embedded tissue sections of Kaposi sarcoma. As such, it is an extremely useful tool for differentiating between Kaposi sarcoma and other vascular and nonvascular spindle cell lesions, which do not express human herpes virus 8 latent nuclear antigen-1.
卡波西肉瘤是一种低级别血管肿瘤，分子分析显示其一致表达人疱疹病毒8的潜伏核抗原-1。将卡波西肉瘤与其他良性或恶性血管肿瘤以及其他非血管性梭形细胞软组织肿瘤区分开来可能具有挑战性。因此，在固定组织中检测人疱疹病毒8具有诊断价值。最近，一种针对人疱疹病毒8潜伏核抗原-1的单克隆抗体已可用于商业免疫组织化学分析。我们试图研究该抗体在检测卡波西肉瘤中人疱疹病毒8潜伏核抗原-1方面的敏感性和特异性。使用针对人疱疹病毒8潜伏核抗原-1开放阅读框-73的大鼠单克隆抗体（Advanced Biotechnologies Inc.）对21例卡波西肉瘤、9例梭形细胞血管瘤、5例皮肤血管肉瘤、5例隆突性皮肤纤维肉瘤、1例淋巴结血管转化、4例毛发平滑肌瘤、4例淤积性皮炎、4例化脓性肉芽肿和3例梭形黑色素瘤的固定石蜡包埋组织切片进行免疫组织化学检查。组织切片用自动免疫染色仪（Ventana）进行染色，采用热诱导抗原修复，并使用经过改良以检测大鼠抗体的标准DAB检测试剂盒（Ventana）。肿瘤细胞中>10%出现强的、弥漫性核染色被视为阳性结果。总共21例卡波西肉瘤中有21例（100%）显示人疱疹病毒8潜伏核抗原-1呈强的、弥漫性核染色，而所有梭形细胞血管瘤、皮肤血管肉瘤、隆突性皮肤纤维肉瘤、淋巴结血管转化、毛发平滑肌瘤、淤积性皮炎、化脓性肉芽肿和梭形黑色素瘤病例该抗原均为阴性。针对人疱疹病毒8潜伏核抗原-1开放阅读框-73的单克隆抗体是卡波西肉瘤石蜡包埋组织切片中人疱疹病毒8感染的高度敏感和特异性标志物。因此，它是区分卡波西肉瘤与其他不表达人疱疹病毒8潜伏核抗原-1的血管性和非血管性梭形细胞病变的极其有用的工具。
