Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.
Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy.
J Clin Pathol. 2022 Jan;75(1):45-49. doi: 10.1136/jclinpath-2020-206962. Epub 2021 Jan 28.
The diagnosis of metastatic cutaneous melanoma (CM) on lymph node fine needle aspiration samples may be challenging and usually requires confirmation by immunocytochemistry. However, the cytological material could be too scant to order a broad panel of markers. In this case, the pathologist is forced to choose the most advantageous antibodies. The most commonly used melanocytic markers include S100, Melan-A, HMB45 and SOX10 but their diagnostic yield on cytological samples has been poorly studied. The current work aimed to evaluate the diagnostic performance of melanocytic markers when applied to cell blocks obtained from fine needle aspiration cytology (FNAC) of lymph node metastases from CM.
S100, Melan-A, HMB45 and SOX10 were tested on cell block sections of 38 lymphnode metastases from CM diagnosed by cytology. A combined score was built to evaluate each immunostaining, considering the intensity of the staining and the percentage of stained neoplastic cells.
S100 and SOX10 revealed a higher sensitivity (100%) than Melan-A and HMB45 for the diagnosis of metastatic CM. Furthermore, SOX10 emerged as the melanocytic marker with the best staining performance.
SOX10 has a 100% detection rate and the most easily interpretable staining pattern compared with other melanocytic markers. Therefore, it is strongly recommended that SOX10 is included in the minimal immunocytochemical panel for the diagnostic evaluation of lymph node FNAC in patients with suspected CM metastasis.
转移性皮肤黑色素瘤（CM）在淋巴结细针穿刺样本中的诊断可能具有挑战性，通常需要免疫细胞化学来确认。然而，细胞学材料可能太少，无法订购广泛的标志物组合。在这种情况下，病理学家被迫选择最有利的抗体。最常用的黑素细胞标志物包括 S100、Melan-A、HMB45 和 SOX10，但它们在细胞学样本中的诊断效果研究甚少。本研究旨在评估黑素细胞标志物在 CM 淋巴结转移的细针抽吸细胞学（FNAC）获得的细胞块上的应用的诊断性能。
对 38 例经细胞学诊断为 CM 淋巴结转移的细胞块切片进行 S100、Melan-A、HMB45 和 SOX10 检测。建立了一个综合评分来评估每种免疫染色，考虑染色强度和染色肿瘤细胞的百分比。
S100 和 SOX10 对转移性 CM 的诊断敏感性（100%）高于 Melan-A 和 HMB45。此外，SOX10 是表现出最佳染色性能的黑素细胞标志物。
与其他黑素细胞标志物相比，SOX10 的检测率为 100%，且染色模式最易解读。因此，强烈建议在诊断评估疑似 CM 转移的淋巴结 FNAC 时，将 SOX10 纳入最小免疫细胞化学组合。
