纤维组织细胞性病变中的免疫组织化学标志物：凝血因子XIIIa、CD34、S-100和p75。
Immunohistochemical markers in fibrohistiocytic lesions: factor XIIIa, CD34, S-100 and p75.
作者信息
West Kelly L, Cardona Diana M, Su Zuowei, Puri Puja K
机构信息
*Department of Pathology. Duke University Medical Center, Durham, NC; and †Laboratory Corporation of America, Center for Molecular Biology and Pathology, Research Triangle Park, NC.
出版信息
Am J Dermatopathol. 2014 May;36(5):414-9. doi: 10.1097/DAD.0b013e3182a70396.
BACKGROUND
The distinction between dermatofibroma (DF), dermatofibrosarcoma protuberans (DFSP), and other benign and malignant cutaneous spindle cell lesions frequently requires immunohistochemical staining. CD34 and factor XIIIa are the most commonly used immunostains; however, they may exhibit aberrant expression and introduce the potential for misdiagnosis. There is some data supporting that p75 and S100A6 may be additional helpful immunohistochemical markers.
METHODS
We undertook a large case series examining the use of CD34 and factor XIIIa as well as p75 and S100A6 in DF, cellular DF, DFSP, indeterminate fibrohistiocytic lesion, and scar.
RESULTS
As expected, CD34 stained DFSP, although it was usually negative in DF. Factor XIIIa was generally positive in DF and negative in DFSP. There were exceptions in both cases of DF and DFSP. S100A6 was routinely negative in all entities studied. P75 was negative in all cases except DFSP, approximately half of which showed weak and/or patchy positivity.
CONCLUSIONS
We conclude that to date, CD34 and factor XIIIa remain the most reliable immunohistochemical markers for DF and DFSP.
背景
皮肤纤维瘤（DF）、隆突性皮肤纤维肉瘤（DFSP）与其他良性及恶性皮肤梭形细胞病变之间的鉴别诊断常常需要进行免疫组织化学染色。CD34和因子ⅩⅢa是最常用的免疫染色剂；然而，它们可能会出现异常表达，从而导致误诊。有一些数据支持p75和S100A6可能是另外有用的免疫组织化学标志物。
方法
我们进行了一个大型病例系列研究，检测CD34、因子ⅩⅢa以及p75和S100A6在皮肤纤维瘤、细胞性皮肤纤维瘤、隆突性皮肤纤维肉瘤、不确定的纤维组织细胞性病变及瘢痕中的应用情况。
结果
正如预期，CD34在隆突性皮肤纤维肉瘤中呈阳性染色，而在皮肤纤维瘤中通常为阴性。因子ⅩⅢa在皮肤纤维瘤中一般呈阳性，在隆突性皮肤纤维肉瘤中呈阴性。在皮肤纤维瘤和隆突性皮肤纤维肉瘤病例中均有例外情况。S100A6在所研究的所有病变中均呈常规阴性。除隆突性皮肤纤维肉瘤外，p75在所有病例中均为阴性，其中约一半呈弱阳性和/或斑片状阳性。
结论
我们得出结论，迄今为止，CD34和因子ⅩⅢa仍然是皮肤纤维瘤和隆突性皮肤纤维肉瘤最可靠的免疫组织化学标志物。
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