Hancock C, Allen B C, Herrera G A
Department of Pathology, University of Mississippi Medical Center, Jackson 39216-4505.
Arch Pathol Lab Med. 1991 Sep;115(9):886-90.
Several studies have suggested that HMB-45 is a specific marker for melanoma, presumably due to its ability to detect a glycoprotein that is present in premelanosomes. The present study was conducted to evaluate whether HMB-45 is an absolutely specific antigenic determinant for melanoma and the role that testing with this antibody has in the differential diagnostic workup of amelanotic melanoma vs adenocarcinoma. Formaldehyde solution-fixed, paraffin-embedded tissue samples from 52 adenocarcinomas (primary or metastatic) and five melanomas (two primary and three metastatic) were immunostained with the use of a commercially available monoclonal antibody (MoAb), ie, HMB-45 (Enzo), a polyclonal antibody to S100 protein, a wide-spectrum keratin polyclonal antibody, and a keratin MoAb, ie, AE1/AE3. Approximately 10% (ie, 9.6%) of the adenocarcinomas (five cases) expressed HMB-45 with varied intensity and distribution. Positive primary tumors (n = 3) included one each from the breast, colon, and kidney; positive metastatic tumors (n = 2) included one each from the breast and endometrium. Fifty-two percent of the adenocarcinomas were positive for S100 protein. One renal carcinoma was negative for both keratins when tested with the AE1/AE3 MoAb and polyclonal antibody (Dako). This was the only adenocarcinoma that was negative when the keratin polyclonal antibody (Dako) was used. All but one additional adenocarcinoma demonstrated keratin expression when the AE1/AE3 MoAb was used for testing. This study showed that HMB-45 is not absolutely specific for melanoma. HMB-45 may react with some adenocarcinomas, at least when tested with the commercially available MoAb (Enzo). This fact, in conjunction with aberrant keratin expression by some melanomas and S100 protein expression by adenocarcinomas and other neoplasms other than melanomas, should be considered when antibody panels are evaluated in the workup of poorly differentiated tumors. However, HMB-45 appears to be the most specific marker that is available at the present time for supporting a diagnosis of melanoma.
多项研究表明，HMB - 45是黑色素瘤的一种特异性标志物，可能是因为它能够检测到存在于前黑素小体中的一种糖蛋白。本研究旨在评估HMB - 45是否为黑色素瘤的绝对特异性抗原决定簇，以及使用该抗体检测在无色素性黑色素瘤与腺癌的鉴别诊断检查中所起的作用。使用市售单克隆抗体（MoAb）即HMB - 45（安捷伦）、S100蛋白多克隆抗体、广谱角蛋白多克隆抗体和角蛋白MoAb即AE1/AE3，对52例腺癌（原发性或转移性）和5例黑色素瘤（2例原发性和3例转移性）的甲醛溶液固定、石蜡包埋组织样本进行免疫染色。约10%（即9.6%）的腺癌（5例）表达HMB - 45，强度和分布各异。阳性原发性肿瘤（n = 3）分别来自乳腺、结肠和肾脏各1例；阳性转移性肿瘤（n = 2）分别来自乳腺和子宫内膜各1例。52%的腺癌S100蛋白呈阳性。用AE1/AE3 MoAb和多克隆抗体（达科）检测时，1例肾癌的两种角蛋白均为阴性。这是使用角蛋白多克隆抗体（达科）检测时唯一呈阴性的腺癌。使用AE1/AE3 MoAb检测时，除1例腺癌外，其余所有腺癌均显示角蛋白表达。本研究表明，HMB - 45并非黑色素瘤的绝对特异性标志物。HMB - 45可能与某些腺癌发生反应，至少在用市售MoAb（安捷伦）检测时如此。在评估低分化肿瘤的检查中使用抗体组合时，应考虑到这一事实，以及某些黑色素瘤的异常角蛋白表达和腺癌及黑色素瘤以外的其他肿瘤的S100蛋白表达。然而，HMB - 45似乎是目前可用于支持黑色素瘤诊断的最特异性标志物。
