Department of Pathology, Yale School of Medicine, New Haven, Connecticut 06520, USA.
Arch Pathol Lab Med. 2013 Aug;137(8):1063-73. doi: 10.5858/arpa.2012-0284-OA.
The distribution of the standard melanoma antibodies S100, HMB-45, and Melan-A has been extensively studied. Yet, the overlap in their expression is less well characterized.
To determine the joint distributions of the classic melanoma markers and to determine if classification according to joint antigen expression has prognostic relevance.
S100, HMB-45, and Melan-A were assayed by immunofluorescence-based immunohistochemistry on a large tissue microarray of 212 cutaneous melanoma primary tumors and 341 metastases. Positive expression for each antigen required display of immunoreactivity for at least 25% of melanoma cells. Marginal and joint distributions were determined across all markers. Bivariate associations with established clinicopathologic covariates and melanoma-specific survival analyses were conducted.
Of 322 assayable melanomas, 295 (91.6%), 203 (63.0%), and 236 (73.3%) stained with S100, HMB-45, and Melan-A, respectively. Twenty-seven melanomas, representing a diverse set of histopathologic profiles, were S100 negative. Coexpression of all 3 antibodies was observed in 160 melanomas (49.7%). Intensity of endogenous melanin pigment did not confound immunolabeling. Among primary tumors, associations with clinicopathologic parameters revealed a significant relationship only between HMB-45 and microsatellitosis (P = .02). No significant differences among clinicopathologic criteria were observed across the HMB-45/Melan-A joint distribution categories. Neither marginal HMB-45 (P = .56) nor Melan-A (P = .81), or their joint distributions (P = .88), was associated with melanoma-specific survival.
Comprehensive characterization of the marginal and joint distributions for S100, HMB-45, and Melan-A across a large series of cutaneous melanomas revealed diversity of expression across this group of antigens. However, these immunohistochemically defined subclasses of melanomas do not significantly differ according to clinicopathologic correlates or outcome.
标准黑色素瘤抗体 S100、HMB-45 和 Melan-A 的分布已得到广泛研究。然而，它们的表达重叠情况还不太清楚。
确定经典黑色素瘤标志物的联合分布，并确定根据联合抗原表达进行分类是否具有预后相关性。
在一个包含 212 例皮肤黑色素瘤原发肿瘤和 341 例转移瘤的大型组织微阵列上，通过免疫荧光免疫组化检测 S100、HMB-45 和 Melan-A 的表达。每个抗原的阳性表达需要显示至少 25%的黑色素瘤细胞的免疫反应性。在所有标志物上确定边缘和联合分布。进行与既定临床病理协变量的双变量关联和黑色素瘤特异性生存分析。
在 322 例可检测的黑色素瘤中，分别有 295 例（91.6%）、203 例（63.0%）和 236 例（73.3%）用 S100、HMB-45 和 Melan-A 染色。27 例黑色素瘤代表了一组多样化的组织病理学特征，S100 阴性。160 例黑色素瘤同时表达所有 3 种抗体（49.7%）。内源性黑色素色素的强度不影响免疫标记。在原发肿瘤中，与临床病理参数的关联仅显示 HMB-45 与微卫星不稳定性之间存在显著关系（P =.02）。在 HMB-45/Melan-A 联合分布类别中，没有观察到临床病理标准之间的显著差异。HMB-45 的边缘分布（P =.56）或 Melan-A（P =.81），或它们的联合分布（P =.88）均与黑色素瘤特异性生存无关。
对 S100、HMB-45 和 Melan-A 的边缘和联合分布进行全面描述，跨越了一组大型皮肤黑色素瘤，显示了这组抗原表达的多样性。然而，这些免疫组织化学定义的黑色素瘤亚类在临床病理相关性或结果方面没有显著差异。
