Kanik A B, Yaar M, Bhawan J
Department of Dermatology, Boston University School of Medicine, MA 02118, USA.
J Cutan Pathol. 1996 Jun;23(3):205-10. doi: 10.1111/j.1600-0560.1996.tb01468.x.
Melanoma is a malignant tumor with a varied histologic appearance. Melanoma composed of spindle cells may include desmoplastic and neurotropic melanoma. The histologic diagnosis of desmoplastic and neurotropic melanoma can be difficult. Although S100 protein stains a majority of these melanomas, the staining may be weak or focal. HMB-45, a more specific marker of melanoma, is frequently negative in desmoplastic and neurotropic melanoma. In order to aid the identification of desmoplastic and neurotropic melanoma, we stained 13 spindle cell melanomas (5 neurotropic melanomas, 5 desmoplastic melanomas, 3 spindle cell melanomas without either desmoplasia or neurotropism) with p75 NGF-R and compared the staining results with S100 and HMB-45. p75 NGF-R is the low affinity nerve growth factor receptor reported to be present on the surface of neural-crest-derived cells. Conventional melanoma as well as neurotized nevi, neurofibroma, spindle squamous carcinoma, atypical fibroxanthoma, dermatofibroma and scars were also stained with p75 NGF-R. p75 NGF-R stained all of the desmoplastic and neurotropic melanomas tested. In each of these cases, negative HMB-45 staining of the spindle cells was seen. In many cases the number and intensity of the spindle cells staining with p75 NGF-R was greater than with S100. Neurofibroma, neurotized nevi and focal cells in round cell melanoma also were stained with p75 NGF-R. All the squamous cell carcinomas, atypical fibroxanthomas, dermatofibromas and scars were negative for p75 NGF-R. Based on our results, p75 NGF-R may be useful as an additional confirmatory antibody in a melanoma panel, especially in differentiating desmoplastic and neurotropic melanomas from non-neural-crest-derived spindle cell lesions. We feel it also can be helpful in better identifying margins of excision of these melanomas. p75 NGF-R, like S100 protein, will not differentiate desmoplastic and neurotropic melanomas from other neural-crest-derived lesions.
黑色素瘤是一种组织学表现多样的恶性肿瘤。由梭形细胞组成的黑色素瘤可能包括促纤维增生性和向神经性黑色素瘤。促纤维增生性和向神经性黑色素瘤的组织学诊断可能具有挑战性。尽管S100蛋白可使大多数此类黑色素瘤染色，但染色可能较弱或呈局灶性。HMB-45是一种更具特异性的黑色素瘤标志物，在促纤维增生性和向神经性黑色素瘤中常呈阴性。为了辅助促纤维增生性和向神经性黑色素瘤的鉴别诊断，我们用p75 NGF-R对13例梭形细胞黑色素瘤（5例向神经性黑色素瘤、5例促纤维增生性黑色素瘤、3例既无促纤维增生也无向神经表现的梭形细胞黑色素瘤）进行染色，并将染色结果与S100和HMB-45进行比较。p75 NGF-R是低亲和力神经生长因子受体，据报道存在于神经嵴衍生细胞表面。传统黑色素瘤以及神经化痣、神经纤维瘤、梭形鳞状细胞癌、非典型纤维黄色瘤、皮肤纤维瘤和瘢痕也用p75 NGF-R进行染色。p75 NGF-R使所有检测的促纤维增生性和向神经性黑色素瘤均呈阳性染色。在每例此类病例中，可见梭形细胞HMB-45染色阴性。在许多病例中，p75 NGF-R染色的梭形细胞数量和强度大于S100染色。神经纤维瘤、神经化痣和圆形细胞黑色素瘤中的局灶性细胞也被p75 NGF-R染色。所有鳞状细胞癌、非典型纤维黄色瘤、皮肤纤维瘤和瘢痕p75 NGF-R染色均为阴性。根据我们的结果，p75 NGF-R可作为黑色素瘤检测组中的一种额外确证抗体，尤其有助于将促纤维增生性和向神经性黑色素瘤与非神经嵴衍生的梭形细胞病变区分开来。我们认为它也有助于更好地确定这些黑色素瘤的切除边缘。与S100蛋白一样，p75 NGF-R无法将促纤维增生性和向神经性黑色素瘤与其他神经嵴衍生病变区分开来。
