Helmke Burkhard Maria, Renner Marcus, Poustka Annemarie, Schirmacher Peter, Mollenhauer Jan, Kern Michael André
Institute of Pathology, University of Heidelberg, Heidelberg, Germany.
Histopathology. 2009 Jan;54(2):233-40. doi: 10.1111/j.1365-2559.2008.03200.x.
Anorectal melanoma (AM) forms a rare but highly malignant subset of mucosal melanoma with an extremely poor prognosis. Although AMs display histological and immunohistochemical features very similar to cutaneous melanoma (CM), no association exists either with exposure to ultraviolet light or with melanocytic naevi. While AMs are clearly distinguished from CM by displaying few BRAF mutations, they are commonly indistinguishable from CM at the level of gene expression. The aim was to carry out expression analyses of classical immunohistochemical markers and of the protein deleted in malignant brain tumours 1 (DMBT1) in cases of primary anorectal malignant melanoma and CM.
Expression analyses of classical immunohistochemical markers (S100, HMB45, Melan A and MiTF) and of the protein DMBT1 were carried out in 27 cases of primary anorectal malignant melanoma and 26 cases of CM. All AM cases analysed showed expression of at least three of the classical markers for melanoma. However, immunohistochemistry showed 19 out of 27 AM to be positive for DMBT1, which represented a statistically significant difference (P = 0.0009) compared with CM (six out of 26), which more commonly are negative for DMBT1 expression.
These results identify DMBT1 as a molecular feature that may allow distinction between AM and CM and support the notion that AM represents an entity molecularly distinct from CM.
肛管直肠黑色素瘤(AM)是黏膜黑色素瘤中一种罕见但高度恶性的亚型,预后极差。尽管AM在组织学和免疫组化特征上与皮肤黑色素瘤(CM)非常相似,但与紫外线暴露或黑素细胞痣均无关联。虽然AM通过显示较少的BRAF突变与CM明显区分,但在基因表达水平上它们通常与CM难以区分。目的是对原发性肛管直肠恶性黑色素瘤和CM病例进行经典免疫组化标志物以及恶性脑肿瘤1缺失蛋白(DMBT1)的表达分析。
对27例原发性肛管直肠恶性黑色素瘤和26例CM进行了经典免疫组化标志物(S100、HMB45、Melan A和MiTF)以及蛋白DMBT1的表达分析。所有分析的AM病例均显示至少表达三种黑色素瘤的经典标志物。然而,免疫组化显示27例AM中有19例DMBT1呈阳性,与CM(26例中有6例)相比,这具有统计学显著差异(P = 0.0009),CM中DMBT1表达通常为阴性。
这些结果确定DMBT1为一种分子特征,可用于区分AM和CM,并支持AM代表一种在分子上与CM不同的实体这一观点。