Voiculescu Vlad-Mihai, Popescu Alina-Ioana, Costache Mariana
Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Elias Emergency University Hospital, 011461 Bucharest, Romania.
Cancers (Basel). 2025 May 25;17(11):1769. doi: 10.3390/cancers17111769.
: With its incidence on the rise, a high mortality rate, and great costs associated with its treatment, melanoma represents an important challenge for healthcare systems, clinicians, and pathologists. Therefore, an emphasis should be placed on its early and correct diagnosis, as well as the appropriate assessment of prognostic and predictive factors. Immunohistochemistry (IHC) is an ancillary test that can provide invaluable information for diagnosing melanoma, especially in complex cases. : The aim of this systematic review is to gather the available information regarding the use of IHC markers in the diagnosis, differential diagnosis, prognosis, staging, and treatment of melanoma in a format that is easy to access for clinicians and pathologists. A comprehensive search of the literature was conducted and resulted in one hundred and forty-seven studies being included in this systematic review. The results were grouped thematically by specific IHC markers. : The IHC markers specific to melanocytic differentiation, like S100, SOX10, and Melan-A/MART1, were consistent across studies as being positive in most cases of melanoma, with rare exceptions. HMB-45 and PRAME can provide additional information, especially for differential diagnoses between benign and malignant melanocytic lesions. MITF, Ki67, BRAF, and PD-L1 are associated with prognosis factors, like the Breslow thickness, tumour ulceration, type of inflammatory infiltrate, and response to treatment. : IHC markers are an invaluable tool for the diagnosis and differential diagnosis of melanoma, especially in cases that lack the characteristic histopathological aspects. In addition, IHC provides prognostic factors and can help in predicting the tumour's response to various treatments.
黑色素瘤的发病率呈上升趋势，死亡率高，治疗成本巨大，这对医疗系统、临床医生和病理学家来说是一项重大挑战。因此，应重视其早期正确诊断以及对预后和预测因素的恰当评估。免疫组织化学（IHC）是一项辅助检测，可为黑色素瘤的诊断提供宝贵信息，尤其是在复杂病例中。
本系统评价的目的是以临床医生和病理学家易于获取的形式收集有关免疫组织化学标志物在黑色素瘤诊断、鉴别诊断、预后、分期和治疗中应用的现有信息。对文献进行了全面检索，共有147项研究纳入本系统评价。结果按特定免疫组织化学标志物进行主题分组。
黑色素细胞分化特异性的免疫组织化学标志物，如S100、SOX10和Melan - A/MART1，在大多数黑色素瘤病例中呈阳性，各研究结果一致，仅有罕见例外。HMB - 45和PRAME可提供额外信息，特别是用于良性和恶性黑色素细胞病变的鉴别诊断。MITF、Ki67、BRAF和PD - L1与预后因素相关，如Breslow厚度、肿瘤溃疡、炎症浸润类型和对治疗的反应。
免疫组织化学标志物是黑色素瘤诊断和鉴别诊断的宝贵工具，尤其是在缺乏典型组织病理学特征的病例中。此外，免疫组织化学可提供预后因素，并有助于预测肿瘤对各种治疗的反应。
