The p16-Ki-67-HMB45 Immunohistochemistry Scoring System is Highly Concordant With the Fluorescent In Situ Hybridization Test to Differentiate Between Melanocytic Nevi and Melanomas
The p16-Ki-67-HMB45 Immunohistochemistry Scoring System is Highly Concordant With the Fluorescent In Situ Hybridization Test to Differentiate Between Melanocytic Nevi and Melanomas
复制标题
DOI：
10.1097/pai.0000000000000428
复制
发表时间：
2018-07-01
影响因子：
1.6
通讯作者：
De Braekeleer, Marc
中科院分区：
文献类型：
--
作者：
Uguen, Arnaud;Uguen, Marie;De Braekeleer, Marc
黑色素瘤的治疗需要早期诊断和广泛的手术切除原发肿瘤。从组织病理学的角度来看，黑色素瘤和痣之间的鉴别诊断有时很困难，可能需要辅助诊断工具。最近，荧光原位杂交（FISH）和p16-Ki-67-HMB 45联合免疫组织化学已被提出作为辅助诊断方法的例子，以帮助分类黑素细胞肿瘤为良性或恶性。在这项研究中，我们比较FISH和p16-Ki-67-HMB 45免疫组化在一组黑色素瘤和痣。共101例福尔马林固定和石蜡包埋的肿瘤样本（44例黑色素瘤和57例痣），采用6、8、9和11号染色体FISH和p16-Ki-67-HMB 45免疫组化进行分析。任何染色体不平衡和/或p16-Ki-67-HMB 45免疫组化综合评分≥ 4分被认为反映了“有利”恶性肿瘤。使用FISH，44个黑色素瘤中有42个至少有1个染色体不平衡，而2个黑色素瘤和所有痣没有。每种黑色素瘤，包括6种挑战性肿瘤，具有4或更高的p16 Ki-67-HMB 45免疫组织化学组合评分，并且每种痣具有低于4的评分。这反映了我们的肿瘤组中FISH、免疫组化和明确的组织病理学诊断之间的良好一致性。我们的结论是，FISH和p16-Ki-67-HMB 45联合免疫组化是有价值的辅助诊断工具，以帮助病理学家分类痣或黑色素瘤的黑色素细胞肿瘤。
The treatment of melanoma requires early diagnosis and extensive surgical removal of the primary tumor. The differential diagnosis between a melanoma and a nevus is sometimes difficult from a histopathologic point of view and could require ancillary diagnostic tools. Recently, both fluorescent in situ hybridization (FISH) and p16-Ki-67-HMB45 combined immunohistochemistry have been proposed as examples of ancillary diagnostic methods to help classify melanocytic tumors as benign or malignant. In this study, we compare FISH and p16-Ki-67-HMB45 immunohistochemistry in a set of melanomas and nevi. A total of 101 formalin-fixed and paraffin-embedded tumor samples (44 melanomas and 57 nevi) were analyzed using FISH for chromosomes 6, 8, 9, and 11 and p16-Ki-67-HMB45 immunohistochemistry. Any chromosomal imbalances and/or a p16-Ki-67-HMB45 immunohistochemistry combined score of 4 or higher were considered to reflect a "favor" malignant tumor. Using FISH, 42 out of 44 melanomas presented at least 1 chromosomal imbalance, whereas 2 melanomas and all nevi did not. Each melanoma, including 6 challenging tumors, had a pl 6Ki-67-HMB45 immunohistochemistry combined score of 4 or higher and every nevus had a score inferior to 4. This reflects an excellent strength of agreement between FISH, immunohistochemistry, and definitive histopathologic diagnosis in our tumor set. We conclude that both FISH and p16-Ki-67-HMB45 combined immunohistochemistry are valuable ancillary diagnostic tools to help pathologists classify melanocytic tumors as nevi or melanomas.