HMB-45, S-100, NK1/C3, and MART-1 in metastatic melanoma.
The diagnosis of melanoma metastatic to lymph node remains a difficult problem given its histological diversity. We examined the staining patterns of S-100, NK1/C3, HMB-45, and MART-1 (DC10) in melanoma metastases to lymph nodes. Immunohistochemical stains were performed on tissue sections of 126 formalin-fixed lymph nodes from 126 patients with an established diagnosis of metastatic melanoma. A total of 98% of cases (123 of 126) stained positive for S-100, 93% (117 of 125) stained positive for NK1/C3, 82% (103 of 126) stained positive for MART-1, and 76% (95 of 125) stained positive for HMB-45. The distribution and intensity of staining varied among these markers. A diffuse staining pattern, defined as >50% of tumor cells stained, was observed in 83% of MART-1-positive cases but in only 56% of S-100-positive cases, 48% of NK1/C3-positive cases, and 34% of HMB-45-positive cases. A maximally intense signal was almost always observed for MART-1 (83% of positive cases) but was rarely observed for NK1/C3 (20%). S-100 and HMB-45 showed maximally intense staining in 50% and 54% of cases, respectively. S-100 and NK1/C3 stained both histiocytes and melanocytes, whereas MART-1 and HMB-45 stained only melanocytes. Seventy-eight cases (63%) stained positive for all 4 markers, 17 cases (14%) stained for all markers except HMB-45, 13 cases (10%) stained for all markers except MART-1, 6 cases (5%) stained only with S-100 and NK1/C3, 4 cases (3%) stained only with S-100 and HMB-45, and 2 cases stained for all markers except S-100. One case each stained for the following: only S-100, only S-100 and HMB-45, and all markers except NK1/C3. One case exhibited absence of staining for any of these markers. We demonstrate that lymph node metastases of melanoma are heterogeneous with regard to tumor marker expression. S-100 and NK1/C3 were the most sensitive stains for detecting metastatic melanoma; however, they both also stain other nontumor cells in lymph nodes. MART-1 did not stain histiocytes and exhibited a more frequently intense and diffuse staining pattern than NK1/C3. HMB-45 was less sensitive and demonstrated less diffuse staining than MART-1.
Department of Pathology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada.
Judit
J
Zubovits
Elizabeth
E
Buzney
Lawrence
L
Yu
Lyn M
LM
Duncan
D000941:Antigens / Q000032:analysis*; D000951:Antigens, Neoplasm / Q000032:analysis; D000954:Antigens, Surface; D014408:Biomarkers, Tumor / Q000032:analysis*; D003176:Complement C3 / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D037181:Lectins, C-Type; D008198:Lymph Nodes / Q000737:chemistry* / Q000473:pathology*; D008207:Lymphatic Metastasis; D058965:MART-1 Antigen; D008545:Melanoma / Q000737:chemistry* / Q000556:secondary*; D058950:Melanoma-Specific Antigens; D055651:NK Cell Lectin-Like Receptor Subfamily B; D009363:Neoplasm Proteins / Q000032:analysis*; D011506:Proteins / Q000032:analysis*; D009418:S100 Proteins / Q000032:analysis*; D012878:Skin Neoplasms / Q000737:chemistry / Q000473:pathology
D000941:Antigens; D000951:Antigens, Neoplasm; D000954:Antigens, Surface; D014408:Biomarkers, Tumor; D003176:Complement C3; C527203:KLRB1 protein, human; D037181:Lectins, C-Type; D058965:MART-1 Antigen; C548667:MLANA protein, human; D058950:Melanoma-Specific Antigens; D055651:NK Cell Lectin-Like Receptor Subfamily B; D009363:Neoplasm Proteins; D011506:Proteins; D009418:S100 Proteins