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目的探讨免疫组化在无色素性恶性黑色素瘤诊断和鉴别诊断的应用价值。方法回顾分析３７例可疑无色素性恶性黑色素瘤的组织学特点并进行免疫组化研究。结果３７例中１６例ＨＭＢ４５、Ｓ－１００和Ｖｉｍｅｎｔｉｎ阳性，证实为恶性黑色素瘤；２１例ＨＭＢ４５阴性，阴性者中７例ｃｙｔｏｋｅｒａｔｉｎ和ＣＥＡ、ＥＭＡ阳性，诊断为癌；８例ＬＣＡ阳性，诊断为淋巴瘤，６例Ｖｉｍｅｎｔｉｎ等阳性，诊断为肉瘤。结论ＨＭＢ４５和Ｓ－１００是无色素性恶性黑色素瘤的诊断性标记物，前者更具特异性。ＨＭＢ４５联合其它相关抗体可以作为无色素性恶黑鉴别诊断指标。
Objective To investigate the value of immunohistochemistry in the diagnosis and differential diagnosis of non-pigmented malignant melanoma. Methods The histological features of 37 suspected non-pigmented malignant melanomas were retrospectively analyzed and immunohistochemically studied. Results Among the 37 cases, 16 cases were positive for HMB45, S-100 and Vimentin, which were confirmed as malignant melanoma; 21 cases were negative for HMB45, 7 cases were negative for cytokeratin, CEA, and EMA were positive, and the diagnosis was cancer; 8 cases were positive for LCA and diagnosed as lymph Tumor, positive for Vimentin in 6 cases, diagnosed as sarcoma. Conclusions HMB45 and S-100 are diagnostic markers for non-pigmented malignant melanoma. The former is more specific. HMB45 combined with other related antibodies can be used as a differential diagnostic indicator for non-pigmented ehv black.