WESTPORT, CT (Reuters Health) – Immunocytochemical detection of microphthalmia transcription factor (Mitf) is a sensitive and specific indicator of malignant melanoma, outperforming two commonly used immunologic melanocytic markers, S-100 protein and HMB-45 antigen, according to a recent study.
Dr. Christine C. Dorvault from Lee Pathology Laboratory in Opelika, Alabama and colleagues report the finding in the current issue of Cancer (Cancer Cytopathology) dated October 25th. The investigators note that the "cytologic diagnosis of metastatic melanoma can be challenging" and that anti-S-100 protein and HMB-45 antigen lack specificity.
Positive nuclear staining with Mitf antibodies in formalin-fixed specimens has been reported to be a useful melanoma marker in surgical pathology. This prompted Dr. Dorvault's team to study the diagnostic value of Mitf in cytologic preparations from 44 patients with melanoma, including 3 with spindle-cell melanoma, and 37 with nonmelanoma malignancies. All 81 specimens were stained with monoclonal antibodies against Mitf and with S-100 protein and HMB-45 antigen.
Mitf had a sensitivity and positive predictive value of greater than 97% as a diagnostic marker of malignant melanoma, compared with a sensitivity of 90.4% for HMB-45 antigen and a specificity of 70.3% for S-100 protein. One nonmelanoma tumor, a metastatic breast tumor, showed weak nuclear staining with Mitf but was not considered positive by the team.
Dr. Dorvault's team concludes that larger studies in patients with "more diverse malignancies" are needed to confirm these findings.
Cancer (Cancer Cytopathol) 2001;93:337-343.
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