Ramachandra S, Gillett C E, Millis R R
Department of Histopathology, United Medical School, Guy's Hospital, London, UK.
Virchows Arch. 1996 Dec;429(6):371-6. doi: 10.1007/BF00198442.
A comparative immunohistochemical study was performed on Paget's disease of the nipple (PDN), extramammary Paget's disease (EMPD) and cutaneous superficial spreading melanoma (SSM) using antibodies to S100, NK1-C3 and HMB45, cytokeratin (CAM 5.2) and c-erb B2 oncoprotein (21N). Conventional histochemical stains for intracytoplasmic mucin and melanin were also done. Of the 20 cases of PDN, positivity was seen in 12 with S100, 16 with NK1-C3, none with HMB45, 20 with CAM 5.2 and 19 with 21N. All 5 cases of EMPD were CAM 5.2 positive and HMB45, S100 and 21N negative. Three EMPD were NK1-C3 positive. All 10 cases of SSM were S100, NK1-C3 and HMB45 positive and all were CAM5.2 and 21N negative. Mucin was demonstrable in 11 cases of PDN and all of EMPD but none of SSM. Melanin was seen in 2 PDN, 3 EMPD and all SSM cases. Identification of mucin and melanin, therefore, proved an unreliable means of distinguishing these diseases. Immunohistochemistry for cytokeratin and HMB45 appear to be the most specific markers in differentiating Paget's disease and SSM. Antibodies to c-erb B2 may also be valuable in this situation.
采用抗S100、NK1-C3和HMB45、细胞角蛋白（CAM 5.2）及c-erb B2癌蛋白（21N）的抗体，对乳头佩吉特病（PDN）、乳房外佩吉特病（EMPD）和皮肤浅表扩散性黑色素瘤（SSM）进行了一项比较免疫组化研究。还进行了胞浆内粘蛋白和黑色素的传统组织化学染色。在20例PDN中，12例S100阳性，16例NK1-C3阳性，HMB45均为阴性，20例CAM 5.2阳性，19例21N阳性。5例EMPD均为CAM 5.2阳性，HMB45、S100和21N均为阴性。3例EMPD为NK1-C3阳性。10例SSM均为S100、NK1-C3和HMB45阳性，均为CAM5.2和21N阴性。11例PDN和所有EMPD可检测到粘蛋白，但SSM均未检测到。2例PDN、3例EMPD和所有SSM病例可见黑色素。因此，粘蛋白和黑色素的鉴定被证明是区分这些疾病的不可靠方法。细胞角蛋白和HMB45的免疫组化似乎是区分佩吉特病和SSM最具特异性的标志物。c-erb B2抗体在这种情况下可能也有价值。
