Expression of soluble adenylyl cyclase in lentigo maligna: use of immunohistochemistry with anti-soluble adenylyl cyclase antibody (R21) in diagnosis of lentigo maligna and assessment of margins.
Expression of soluble adenylyl cyclase in lentigo maligna: use of immunohistochemistry with anti-soluble adenylyl cyclase antibody (R21) in diagnosis of lentigo maligna and assessment of margins.
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DOI：
10.5858/arpa.2011-0617-oa
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发表时间：
2012-12
影响因子：
4.6
通讯作者：
Zembowicz A
中科院分区：
文献类型：
--
作者：
Magro CM;Yang SE;Zippin JH;Zembowicz A
可溶性腺苷酸环化酶（sAC）是产生环磷酸腺苷（cAMP）的酶，环磷酸腺苷是参与调节黑素细胞分化、增殖和黑素生成的信号分子。R21是一种抗sAC的小鼠单克隆抗体，在恶性雀斑样痣中显示出泛核染色模式，显示出可能的诊断和边缘评估实用性。使用先前发表的方案评价了31个恶性雀斑样痣的再切除标本的R21表达。此外，前瞻性分析123例，包括41个雀斑样痣，30个非雀斑样恶性黑色素瘤型，38个雀斑样痣和44个良性痣进行了评估，使用修改后的严格的协议，消除非黑色素细胞染色。恶性雀斑样痣细胞核R21染色的敏感性为87.8%。在40%的其他黑色素瘤中观察到sAC的核表达，而在良性痣中仅为2.3%。R21不染色静息黑素细胞的核，但在28.9%的黑素细胞增生中观察到核染色。R21染色有助于扩大切除边缘的病变范围。在不太严格的条件下检查的情况下，可以通过比较R21和Mart 1/Melan A染色来促进解释。在一个高倍视野内沿着有9个以上的泛核染色黑素细胞且泛核sAC/黑素A比率>0.5与阳性边缘一致，而沿沿着有5个或更少的泛核染色黑素细胞且sAC/黑素A比率<0.3构成阴性边缘。R21在恶性雀斑样痣的诊断中是一个有用的诊断辅助物，并且可以在再次切除时帮助评估边缘。
Soluble adenylyl cyclase (sAC) is an enzyme that generates cyclic adenosine monophosphate (cAMP), a signaling molecule involved in regulating melanocyte differentiation, proliferation and melanogenesis. R21, a mouse monoclonal antibody against sAC, shows a pattern of pan nuclear staining in lentigo maligna showing possible utility for diagnosis and for margin assessment. 31 re-excision specimens for lentigo maligna were evaluated for R21 expression using a previously published protocol. In addition, a prospective analysis of 123 cases including 41 lentigo malignas, 30 non-lentigo maligna type melanomas, 38 lentigos and 44 benign nevi were evaluated using a modified stringent protocol that eliminates non-melanocyte staining. The sensitivity of nuclear staining with R21 in lentigo maligna was 87.8%. Nuclear expression of sAC was observed in 40% of other melanomas and in only 2.3% of the benign nevi. R21 did not stain nuclei of resting melanocytes but nuclear staining was observed in 28.9% of melanocytic hyperplasias. R21 staining facilitated extent of the lesion in resection margins. In cases examined under the less stringent conditions interpretation can be facilitated by comparing R21 and Mart1/Melan A staining. Greater than 9 pan nuclear staining melanocytes within one high power field along with a pan nuclear sAC/melan A ratio >0.5 was consistent with a positive margin while five or less pan nuclear staining melanocytes along with a sAC/melan A ratio of <0.3 constituted a negative margin. R21 is a useful diagnostic adjunct in the diagnosis of lentigo maligna and can facilitate the evaluation of margins in re-excisions.