Steuhl K P, Rohrbach J M, Knorr M, Thiel H J
University of Tübingen Eye Clinic, Germany.
Ophthalmology. 1993 Feb;100(2):208-15. doi: 10.1016/s0161-6420(93)31668-4.
To evaluate the expression of the monoclonal HMB-45 antibody in melanocytic and nonmelanocytic ocular tumors and seek "activated" cellular subpopulations in an attempt to distinguish between benign and malignant melanocytes, to compare HMB-45 and S100 activity, and to determine the specificity of this tumor marker for melanocytic ocular lesions.
Immunohistologic investigations were performed with paraffin-embedded tissue of 10 acquired conjunctival melanoses, 19 conjunctival nevi, 34 conjunctival melanomas, 69 uveal melanomas, 20 basal cell carcinomas of the lid, 20 cystic dermoids, 15 hemangiomas of the lid, 20 conjunctival papillomas, 20 squamous cell carcinomas, 20 pterygia, 11 sebaceous gland carcinomas, 10 retinoblastomas, and 5 choroidal metastatic carcinomas. The avidin-biotin peroxidase technique and monoclonal HMB-45 antibody were used. The distribution of S100 protein was studied in the melanocytic tumors for comparison. To localize the HMB-45 antigen, lowicryl-embedded tissue of uveal melanomas was investigated immunoelectron microscopically.
More than 95% of the conjunctival and choroidal melanomas expressed the HMB-45 antigen, while S100 was found in all melanomas of the conjunctiva and in 91% of the uveal melanomas. In benign melanocytic lesions of the conjunctiva (nevi and melanocytes), especially the intraepithelial and junctional components stained with HMB-45, and at the site of tumor invasion, infiltrating cells showed increased HMB-45 reactivity. On the whole, HMB-45 antigen was less evenly distributed in the melanocytic tumors investigated than S100 antigen. All nonmelanocytic ocular tumors revealed no HMB-45 expression. Retinal pigment epithelium and tumor-free choroid were negative for HMB-45. The HMB-45 antigen was immunoelectron microscopically found in melanosomes at stages II and III.
HMB-45 immunohistology helps in distinguishing melanocytic from nonmelanocytic ocular tumors and often clarifies the front of tumor invasion. The stronger HMB-45 reactivity probably reflects melanocytic activation, but a sharp line between benign and malignant melanocytes cannot be drawn.
评估单克隆HMB - 45抗体在黑素细胞性和非黑素细胞性眼肿瘤中的表达，寻找“活化”的细胞亚群，以试图区分良性和恶性黑素细胞，比较HMB - 45和S100的活性，并确定这种肿瘤标志物对黑素细胞性眼病变的特异性。
对10例获得性结膜黑素沉着、19例结膜痣、34例结膜黑色素瘤、69例葡萄膜黑色素瘤、20例眼睑基底细胞癌、20例囊性皮样瘤、15例眼睑血管瘤、20例结膜乳头状瘤、20例鳞状细胞癌、20例翼状胬肉、11例皮脂腺癌、10例视网膜母细胞瘤和5例脉络膜转移癌的石蜡包埋组织进行免疫组织学研究。采用抗生物素蛋白-生物素过氧化物酶技术和单克隆HMB - 45抗体。在黑素细胞性肿瘤中研究S100蛋白的分布以作比较。为定位HMB - 45抗原，对葡萄膜黑色素瘤的Lowicryl包埋组织进行免疫电镜检查。
超过95%的结膜和脉络膜黑色素瘤表达HMB - 45抗原，而在所有结膜黑色素瘤和91%的葡萄膜黑色素瘤中发现有S100表达。在结膜的良性黑素细胞性病变（痣和黑素细胞）中，尤其是上皮内和交界成分被HMB - 45染色，在肿瘤浸润部位，浸润细胞显示HMB - 45反应性增强。总体而言，在所研究的黑素细胞性肿瘤中，HMB - 45抗原的分布不如S100抗原均匀。所有非黑素细胞性眼肿瘤均未显示HMB - 45表达。视网膜色素上皮和无肿瘤的脉络膜HMB - 45呈阴性。免疫电镜下在II期和III期黑素小体中发现HMB - 45抗原。
HMB - 45免疫组织学有助于区分黑素细胞性和非黑素细胞性眼肿瘤，并常能明确肿瘤浸润前沿。较强的HMB - 45反应性可能反映黑素细胞活化，但良性和恶性黑素细胞之间无法划出明显界限。
