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Comparison of Five Antibodies as Markers in the Diagnosis of Melanoma in Cytologic Preparations

Matthew V. Sheffield MD, Herman Yee MD, PhD, Christine C. Dorvault MD, Katherine N. Weilbaecher MD, Isam A. Eltoum MD, Gene P. Siegal MD, David E. Fisher MD, David C. Chhieng MD
DOI: http://dx.doi.org/10.1309/EWK9-LUPR-6BC5-1GXV 930-936 First published online: 1 December 2002


We determined the sensitivity and specificity of 3 novel antibodies (microphthalmia transcription factor [Mitf], Melan-A, and tyrosinase) as markers for melanoma in cytologic preparations and compared the results with those of commonly used markers (S-100 protein [S-100] and HMB-45). We stained 72 cell blocks from 40 patients with melanoma and 32 with nonmelanocytic malignant neoplasms with antibodies against S-100, HMB-45, Mitf, Melan-A, and tyrosinase. Histologic correlation was available in more than 95% of cases. Nuclear staining for Mitf and cytoplasmic staining for S-100, HMB-45, Melan-A, and tyrosinase in more than 10% of tumor cells was considered positive. All 3 novel markers demonstrated sensitivity superior to S-100 and HMB-45. HMB-45, Melan-A, and Mitf demonstrated specificities of 97%. S-100 protein and tyrosinase were less specific. Sensitivity and specificity for the combination Mitf+/Melan-A+ were 95% and 100%, respectively, whereas they were 80% and 100%, respectively, for S-100+/HMB-45+. Mitf, Melan-A, and tyrosinase are sensitive markers for epithelioid melanoma. Mitf and Melan-A seem more specific than S-100 and tyrosinase. An antibody panel consisting of Mitf and Melan-A is superior to a panel of S-100 and HMB-45 in the diagnosis of melanoma in cytologic specimens.

Key Words:
  • Microphthalmia transcription factor
  • Melan-A
  • Tyrosinase
  • S-100
  • HMB-45
  • Melanoma
  • Immunocytochemistry
  • Cytology