Ikenberg Kristian, Pfaltz Madeleine, Rakozy Christiane, Kempf Werner
Kempf and Pfaltz Histological Diagnostics, Zurich, Switzerland.
J Cutan Pathol. 2012 Mar;39(3):324-30. doi: 10.1111/j.1600-0560.2011.01858.x.
The mitotic rate was introduced as a major prognostic criterion for the staging of thin (≤1.0 mm) melanoma by the 2009 American Joint Committee on Cancer Staging and Classification (seventh edition). The detection of a single mitotic figure changes the tumor stage in thin melanoma. We sought to address the value of a dual staining to facilitate the determination of the mitotic rate and to assign the mitotic activity to melanocytes.
The mitotic rate of melanoma cells was determined by dual phosphohistone-H3 (PHH3)/Melan-A immunohistochemistry. Results were compared with PHH3 staining alone and conventional hematoxylin and eosin (H&E)-stained slides of 15 melanomas with a tumor thickness <1.0 mm.
PHH3 staining clearly labeled cells in the mitotic cell cycle. The mitotic rate in the PHH3/Melan-A dual stain was equal to that derived by H&E staining. Time required for counting mitotic figures was significantly reduced.
The evaluation of mitotic rate with an immunohistochemical dual stain is faster (mean 63.0%) and more reliable than evaluation by routine H&E staining alone. Dual staining immunohistochemistry may be a useful additional tool to standardize the determination of mitotic rate and may be helpful in evaluation of challenging cases.
有丝分裂率被2009年美国癌症联合委员会分期与分类（第七版）作为薄型（≤1.0 mm）黑色素瘤分期的主要预后标准引入。检测到单个有丝分裂象会改变薄型黑色素瘤的肿瘤分期。我们试图探讨双重染色在促进有丝分裂率测定以及将有丝分裂活性归因于黑素细胞方面的价值。
通过磷酸化组蛋白H3（PHH3）/黑素A双重免疫组织化学法测定黑色素瘤细胞的有丝分裂率。将结果与单独的PHH3染色以及15例肿瘤厚度<1.0 mm的黑色素瘤的传统苏木精和伊红（H&E）染色切片进行比较。
PHH3染色清晰地标记了处于有丝分裂细胞周期的细胞。PHH3/黑素A双重染色中的有丝分裂率与H&E染色得出的结果相等。计数有丝分裂象所需的时间显著减少。
与单独的常规H&E染色相比，采用免疫组织化学双重染色评估有丝分裂率更快（平均快63.0%）且更可靠。双重染色免疫组织化学可能是一种有用的辅助工具，可使有丝分裂率的测定标准化，并且可能有助于评估具有挑战性的病例。
