559例皮肤痣样病变的临床与病理分析

Clinicopathologic Characteristics of 559 Cases of Dermal Nevus

目的探讨皮肤痣样病变的临床病理特征与免疫组织化学特点,为鉴别诊断提供较为可靠的参考依据。方法选择559份皮肤痣样病变的临床病例,观察其临床病理特征,并行免疫组织化学染色。结果所有病例中诊断良性黑色素细胞肿瘤480例,黑色素瘤47例,皮脂腺痣21例,表皮痣11例。免疫组织化学显示S-100、MelanA、VIM在良恶性皮肤痣样病变中均弥漫表达,而HMB45和CyclinD1在良恶性皮肤痣样病变中的表达程度和分布上有差异,B淋巴细胞瘤-2基因(B-cell lymphoma,Bcl-2)、P16、Ki-67和P53在恶性中的表达强于良性。结论 HMB45、CyclinD1、Bcl-2、P16、Ki-67和P53等的免疫组织化学染色存在差异,可以作为鉴别诊断的重要参考。

Objective To investigate the clinical and pathological features,immunohistochemical features and differ- ential diagnosis method of dermal nevus. Methods The clinical and pathological features and immunohistochemistry ex- amination of 559 dermal nevus cases were collected and analyzed. Results A total of 559 cases of dermal nevus were diag- nosed as melanocytic tumor with 480 cases, melanoma with 47 cases, nevus sebaceous with 21 cases and epidermal nevi with 11 cases. Immunohistochemi stry showed that S-100, MelanA, VIM were diffuse expression in benign and malignant dermal nevus. And the expression of HMB45 and CyclinD1 were difference in the degree and distribution. The expression of B-cell lymphoma（Bcl-2）, P16, Ki-67, and P53 were stronger in malignant than benign. Conclusion The irnmunohisto- chemical examination of HMIM5, CyclinD1, Bcb2, P16, Ki-67 and P53 have differences, can serve as an important reference for the diagnostic and differential diagnosis.