Ohsie Steven J, Sarantopoulos G Peter, Cochran Alistair J, Binder Scott W
Department of Pathology and Laboratory Medicine, Geffen/UCLA School of Medicine, Los Angeles, CA 90095-1732, USA.
J Cutan Pathol. 2008 May;35(5):433-44. doi: 10.1111/j.1600-0560.2007.00891.x.
Melanoma has a wide spectrum of histologic features which mimic epithelial, hematologic, mesenchymal, and neural tumors. Immunohistochemistry has been the primary tool to distinguish melanomas from these other tumors; it has also been studied for use as an adjunct to distinguish benign and malignant melanocytic tumors and to elucidate prognosis. Furthermore, there has been extensive effort to find a suitable marker to differentiate spindle cell and desmoplastic melanoma from other tumors. We have reviewed the literature investigating melanocytic differentiation markers, proliferation markers, immunomodulatory markers, signaling molecules, and nerve growth factors and receptors. Despite the proliferation of immunohistochemical markers, S-100 remains the most sensitive marker for melanocytic lesions, while markers such as HMB-45, MART-1/Melan-A, tyrosinase, and MITF demonstrate relatively good specificity but not as good sensitivity as S-100. No marker has proven useful in distinguishing spindle cell and desmoplastic melanomas from other tumors. Ki67 remains the most useful adjunct in distinguishing benign from malignant melanocytic tumors. None of the markers reviewed has been shown conclusively to have prognostic value for melanocytic neoplasms.
黑色素瘤具有广泛的组织学特征，可模仿上皮性、血液学、间叶性和神经源性肿瘤。免疫组织化学一直是将黑色素瘤与其他肿瘤区分开来的主要工具；它也被研究用作区分良性和恶性黑素细胞肿瘤以及阐明预后的辅助手段。此外，人们一直在广泛努力寻找一种合适的标志物，以将梭形细胞和促纤维增生性黑色素瘤与其他肿瘤区分开来。我们回顾了研究黑素细胞分化标志物、增殖标志物、免疫调节标志物、信号分子以及神经生长因子和受体的文献。尽管免疫组织化学标志物不断增多，但S-100仍然是黑素细胞病变最敏感的标志物，而诸如HMB-45、MART-1/Melan-A、酪氨酸酶和小眼畸形相关转录因子等标志物显示出相对较好的特异性，但不如S-100敏感。没有一种标志物被证明可用于将梭形细胞和促纤维增生性黑色素瘤与其他肿瘤区分开来。Ki67仍然是区分良性和恶性黑素细胞肿瘤最有用的辅助手段。所审查的标志物中，没有一种被确凿证明对黑素细胞肿瘤具有预后价值。
