Diagnostic Immunohistochemistry in Cutaneous Neoplasia: An Update.
Diagnostic Immunohistochemistry in Cutaneous Neoplasia: An Update.
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DOI：
10.1159/000377698
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发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
Lian CG
中科院分区：
文献类型：
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作者：
Compton LA;Murphy GF;Lian CG
免疫组化（IHC）是诊断肿瘤性皮肤病的重要辅助手段。除了目前使用的许多已建立的IHC标记物外，新的标记物不断出现，尽管它们的普遍接受和常规应用需要可靠的验证。在这里，我们总结了最完善和常用的生物标志物沿着与一系列较新的报告在过去几十年中，无论是证明或持有较高的临床承诺，在皮肤病理学领域。我们还强调了新的IHC标记物在黑色素瘤诊断中的最新应用，包括遗传突变状态标记物[例如BRAF（v-raf鼠肉瘤病毒癌基因同源物B）和NRAS（神经母细胞瘤RAS病毒癌基因同源物）]和表观遗传改变标记物（例如5-羟甲基胞嘧啶）。我们特别关注免疫组化在鉴别诊断以下几类皮肤病变中的作用：黑色素瘤、表皮内上皮瘤样表皮肿瘤、真皮梭形细胞病变、真皮小圆蓝细胞肿瘤和皮肤附件肿瘤。虽然IHC是诊断皮肤病理学的有价值的工具，但标记物的选择和解释必须高度了解临床背景和组织学鉴别诊断。随着我们对肿瘤发生的遗传和表观遗传机制的理解的快速进展，新的IHC标记物将继续出现在诊断性皮肤病理学领域。
Immunohistochemistry (IHC) is an important adjunct in the diagnosis of neoplastic skin diseases. In addition to the many established IHC markers currently in use, new markers continue to emerge, although their general acceptance and routine application requires robust validation. Here, we summarize the most well-established and commonly used biomarkers along with an array of newer ones reported in the past several decades that either demonstrate or hold high clinical promise in the field of cutaneous pathology. We also highlight recent applications of novel IHC markers in melanoma diagnosis including genetic mutation status markers [e.g. BRAF (v-raf murine sarcoma viral oncogene homolog B) and NRAS (neuroblastoma RAS viral oncogene homolog)] and an epigenetic alteration marker (e.g. 5-hydroxymethylcytosine). We specifically focus on the role of IHC in the differential diagnosis of cutaneous lesions that fall under the following categories: melanoma, epidermal tumors with an intraepidermal epitheliomatous pattern, spindle cell lesions of the dermis, small round blue cell tumors of the dermis, and cutaneous adnexal tumors. While IHC is a valuable tool in diagnostic dermatopathology, marker selection and interpretation must be highly informed by clinical context and the histologic differential diagnosis. With rapid progress in our understanding of the genetic and epigenetic mechanisms of tumorigenesis, new IHC markers will continue to emerge in the field of diagnostic dermatopathology.