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目的探讨CD56,CD95,Ki-67,p53,bcl-2,HMB45和S-100在恶性黑色素瘤中的表达,旨在提高黏膜无色素性恶性黑色素瘤的病理诊断率,减少误诊和漏诊,并为临床估计预后、选择治疗方案提供客观指标。方法应用组织芯片和免疫组织化学标记技术,对48例黏膜无色素性恶性黑色素瘤进行标记和分析。结果HMB45与S-100的阳性率分别是100%和85%(41/48)。CD56的阳性率为92%(44/48),在转移灶与原发病例中,两者差异无统计学意义(P>0.05)。CD95的阳性率为85%(41/48),其中11例有淋巴结转移病例,阳性率达100%,Ki-67与p53阳性率是79%(38/48)和58%(28/48)。Ki-67的阳性分布与CD95基本一致。bcl-2的阳性率为40%(19/48)。p53和bcl-2在恶性黑色素瘤中的表达阳性率与CD95比较,差异有统计学意义(P<0.05)。结论CD56在黏膜无色素性恶性黑色素瘤中具有重要的辅助诊断价值;CD95(Fas)与Ki-67的表达对判断恶性黑色素瘤浸润范围及淋巴结转移状况和指导临床治疗有一定的意义。
Objective To investigate the expression of CD56, CD95, Ki-67, p53, bcl-2, HMB45 and S-100 in malignant melanoma and to improve the pathological diagnosis of mucosal non-pigmented melanoma and to reduce misdiagnosis and missed diagnosis To estimate the prognosis of clinical, select treatment options to provide objective indicators. Methods Tissue microarray and immunohistochemistry were used to mark and analyze mucosal non-pigmented malignant melanoma. Results The positive rates of HMB45 and S-100 were 100% and 85%, respectively (41/48). The positive rate of CD56 was 92% (44/48). There was no significant difference between the metastatic lesions and primary cases (P> 0.05). The positive rate of CD95 was 85% (41/48), of which 11 cases had lymph node metastasis, the positive rate was 100%, the positive rates of Ki-67 and p53 were 79% (38/48) and 58% (28/48) . The positive distribution of Ki-67 is basically the same as that of CD95. The positive rate of bcl-2 was 40% (19/48). The positive rate of p53 and bcl-2 expression in malignant melanoma was significantly different from that of CD95 (P <0.05). Conclusion The expression of CD56 (Fas) and Ki-67 in mucosal non-pigmented malignant melanoma has important value in judging the extent of malignant melanoma invasion and lymph node metastasis and guiding the clinical treatment.