Department of Dermatology, University of Colorado, Denver (Health Sciences Center), Aurora, Colorado, USA.
J Am Acad Dermatol. 2012 Jun;66(6):911-6, 916.e1-8. doi: 10.1016/j.jaad.2011.04.025. Epub 2012 Mar 23.
Although criteria are established for the histologic diagnosis of atypical nevi (AN), consensus about the criteria in the diagnosis of and in the definition of AN is limited. Moreover, intraobserver and interobserver differences in the application of these criteria for the diagnosis of AN have been observed.
We sought to determine the usefulness of HLA antigen expression as a biomarker of AN.
The immunoperoxidase reaction was used to mark common nevi and AN with HLA class I heavy chain-, β2microglobulin (β2m)-, and HLA class II β chain-specific monoclonal antibodies.
HLA class I heavy chain, β2m, and HLA class II β chain were expressed in 5 (8.6%) of the 58 common nevi and in 46 (∼72%) of the 64 atypical melanocytic lesions. Among common lesions, only halo nevi expressed HLA class I heavy chain, β2m, and HLA class II β chain. The level of HLA class I heavy chain β2m and of HLA class II β chain expression correlated with the degree of cytologic atypia and architectural disorder.
The number of lesions tested and the subjective nature of the analysis of immunohistochemical staining of tissue sections are both limitations.
The data presented suggest that HLA antigen expression is an objective biomarker that correlates well with the degree of cytologic atypia in AN and may: (1) be useful to distinguish common nevi from AN, and (2) represent a more objective measure to determine which AN should be excised.
虽然已经为非典型痣（AN）的组织学诊断制定了标准，但在诊断和定义 AN 方面对这些标准的共识有限。此外，在应用这些标准诊断 AN 时，观察者内和观察者间的差异已经被观察到。
我们试图确定 HLA 抗原表达作为 AN 生物标志物的有用性。
使用免疫过氧化物酶反应标记常见痣和 AN，使用 HLA Ⅰ类重链、β2 微球蛋白（β2m）和 HLA Ⅱ类β 链特异性单克隆抗体。
在 58 个常见痣中的 5 个（8.6%）和 64 个非典型黑素细胞病变中的 46 个（约 72%）中表达了 HLA Ⅰ类重链、β2m 和 HLA Ⅱ类β 链。在常见病变中，只有 halo nevus 表达了 HLA Ⅰ类重链、β2m 和 HLA Ⅱ类β 链。HLA Ⅰ类重链、β2m 和 HLA Ⅱ类β 链的表达水平与细胞异型性和结构紊乱的程度相关。
测试的病变数量和组织切片免疫组织化学染色分析的主观性都是限制因素。
所提供的数据表明，HLA 抗原表达是一种客观的生物标志物，与 AN 的细胞异型性程度密切相关，并且可能：（1）有助于区分常见痣和 AN；（2）代表一种更客观的方法来确定哪些 AN 应该切除。
