Objective: The recognized surgical method for cutaneous melanoma in China is slow Mohs micrographic surgery,and HE staining was used to evaluate the surgical margin.However,partial sections stained with HE showed ambiguous results.In order to improve the detection rate of positive margins of melanoma,and to seek the best immunohistochemical staining for the margins of slow Mohs micrographic surgery.Methods: From September 2017 to September 2020,the patients were diagnosed as cutaneous melanoma in the Dermatology Department of the First Affiliated Hospital of Xinjiang Medical University,and the patients underwent slow Mohs micrographic surgery of melanoma in our department.The surgical margin was stained with HE pathological sections,and a total of 49 sections were screened out with ambiguous determination of positive or negative surgical margin under HE staining.According to the pathological numbers of the above 49 sections,the corresponding wax blocks were found out.Then 5 pieces of 4μm overgelled white slices were successively cut and stained with HE,SOX10,HMB-45,Melan A and S-100.The number of melanocytes in the epidermis at high power field was counted under microscope.Results: Among the 49 specimens,14 specimens were judged as positive margins by HE staining,with a positive rate of 28.6%.Combined with SOX10,Melan A,HMB-45 and S-100 staining,19 margins were judged to be positive,with A positive rate of 38.8%.Statistical analysis of the number of melanocytes positive for HE,Sox10,Melan A,HMB-45 and S-100 staining showed that P<0.05,indicating that the difference in the number of melanocytes among staining groups was statistically significant.Conclusion: In s MMS of cutaneous melanoma,the surgical margin of melanoma occurring on the face is more prone to ambiguous results under HE staining.In the determination of s MMS cutting edge,HE staining combined with Melan A immunohistochemical staining may be the best combination.Cells with positive Melan A staining ≥15/HP can be considered as having positive cutting edge.Secondly,in combination with HE staining and SOX10 immunohistochemical staining,SOX10 staining positive cells ≥11/HP,which could be considered as positive cutting edge. |