Background: With its incidence on the rise, a high mortality rate, and great costs associated with its treatment, melanoma represents an important challenge for healthcare systems, clinicians, and pathologists. Therefore, an emphasis should be placed on its early and correct diagnosis, as well as the appropriate assessment of prognostic and predictive factors. Immunohistochemistry (IHC) is an ancillary test that can provide invaluable information for diagnosing melanoma, especially in complex cases.Objective: The aim of this systematic review is to gather the available information regarding the use of IHC markers in the diagnosis, differential diagnosis, prognosis, staging, and treatment of melanoma in a format that is easy to access for clinicians and pathologists.Methods:A comprehensive search of the literature was conducted and resulted in one hundred and forty-seven studies being included in this systematic review. The results were grouped thematically by specific IHC markers.Results: The IHC markers specific to melanocytic differentiation, like S100, SOX10, and Melan-A/MART1, were consistent across studies as being positive in most cases of melanoma, with rare exceptions. HMB-45 and PRAME can provide additional information, especially for differential diagnoses between benign and malignant melanocytic lesions. MITF, Ki67, BRAF, and PD-L1 are associated with prognosis factors, like the Breslow thickness, tumour ulceration, type of inflammatory infiltrate, and response to treatment.Conclusions: IHC markers are an invaluable tool for the diagnosis and differential diagnosis of melanoma, especially in cases that lack the characteristic histopathological aspects. In addition, IHC provides prognostic factors and can help in predicting the tumour’s response to various treatments.
背景：黑色素瘤发病率不断上升，死亡率高且治疗成本高昂，对医疗系统、临床医生及病理学家构成重大挑战。因此，应重点关注其早期准确诊断，以及对预后和预测因素的恰当评估。免疫组织化学（IHC）作为一种辅助检测手段，可为黑色素瘤的诊断提供宝贵信息，尤其在复杂病例中。 目的：本系统性综述旨在整合关于IHC标志物在黑色素瘤诊断、鉴别诊断、预后评估、分期及治疗中应用的现有信息，并以便于临床医生和病理学家获取的形式呈现。 方法：通过全面文献检索，共纳入147项研究进行系统性综述。结果按特定IHC标志物进行主题分类汇总。 结果：针对黑色素细胞分化的IHC标志物（如S100、SOX10和Melan-A/MART1）在多数黑色素瘤病例中呈阳性表达，研究结果具有高度一致性，仅存在罕见例外。HMB-45和PRAME可提供补充信息，尤其在良恶性黑色素细胞病变的鉴别诊断中具有价值。MITF、Ki67、BRAF和PD-L1则与预后因素相关，如Breslow厚度、肿瘤溃疡、炎症浸润类型及治疗反应等。 结论：IHC标志物是黑色素瘤诊断与鉴别诊断的重要工具，尤其适用于缺乏典型组织病理学特征的病例。此外，IHC可提供预后相关因素，并有助于预测肿瘤对不同治疗方式的反应。
Immunohistochemistry for Skin Cancers: New Insights into Diagnosis and Treatment of Melanoma
肿瘤(癌症)患者之家