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目的:探讨无色素黑色素瘤组织病理学特点,为快速诊断无色素黑色素瘤提供准确依据。方法:对18例无色素黑色素瘤(实验组)病理切片进行HE、AgNOR特殊染色及免疫组化染色,同时设对照组鉴别对照。分析无色素黑色素瘤病理形态学特点,肿瘤细胞产生的化学成分、不同抗原及其之间相互关系,将肿瘤形态学与功能分析结合起来,为研究、正确诊断肿瘤提供可靠方法。结果:无色素黑色素瘤瘤细胞病理形态变化多端较难鉴别,诊断时可先进行HE染色,根据形态学特点初步诊断;再行AgNOR特殊染色显示黑色素颗粒存在与否,对多数无色素性恶性黑色素瘤在较短时间内快速排除诊断;必要时免疫组化染色进一步确诊。结论:无色素黑色素瘤容易发生局部复发和远处转移,肿瘤预后差。在肉眼和常规HE切片显微镜下常见不到或极少见到黑色素颗粒,经验不足时漏诊、误诊较多见。运用常规HE染色、AgNOR特殊染色及免疫组织染色三者有选择地结合,能快速有效提高肿瘤阳性诊断率,尽早进行手术以减少肿瘤局部扩大及远处转移的机会,延长患者生存期。
Objective: To investigate the histopathological features of amelanotic melanoma and provide an accurate basis for the rapid diagnosis of amelanotic melanoma. Methods: Eighteen cases of non-pigmented melanoma (experimental group) were stained with HE, AgNOR and immunohistochemical staining. At the same time, the control group was used to identify the control group. Analysis of pathomorphological features of amelanotic melanoma, the chemical composition of tumor cells, the different antigens and the relationship between them, the combination of tumor morphology and functional analysis, to provide a reliable method for the study, the correct diagnosis of the tumor. Results: The pathological changes of non-pigmented melanoma cells were more difficult to identify. The diagnosis of HE staining can be carried out first, according to the morphological characteristics of the initial diagnosis; then AgNOR special staining to show the presence or absence of melanin particles, the majority of non-pigmented melanoma Tumor in a short period of time to quickly rule out the diagnosis; if necessary, further confirmed by immunohistochemical staining. Conclusion: Amelanotic melanoma is prone to local recurrence and distant metastasis, the tumor prognosis is poor. In the naked eye and conventional HE slice microscope common or rare to see melanin particles, inexperienced missed diagnosis, misdiagnosis more common. Using conventional HE staining, AgNOR special staining and immunohistochemical staining of the three selective combination can quickly and effectively improve the diagnostic rate of tumor positive, as early as possible surgery to reduce the local tumor expansion and distant metastasis opportunities and extend patient survival.