Hauschild A, Engel G, Brenner W, Gläser R, Mönig H, Henze E, Christophers E
Department of Dermatology, University Hospital, University of Kiel, Kiel, Germany.
Br J Dermatol. 1999 Jun;140(6):1065-71. doi: 10.1046/j.1365-2133.1999.02905.x.
In the immunohistology of malignant melanoma the use of polyclonal antibodies against protein S100 is well established. Recently, it was shown that S100B, a subunit of the S100 protein family, is detectable in the serum of melanoma patients and correlates with the stage of the disease in patients with metastatic melanoma. In the present study, the first evaluation of a large number of treatment observations (n = 77) in 64 different patients during chemotherapy and/or immunotherapy for advanced metastatic melanoma (stage IV) is presented. All patients received treatment according to standardized protocols comprising 8 weeks of treatment followed by routine staging procedures to evaluate therapeutic outcome. In 13 patients with tumour enlargement after first-line therapy, a second-line treatment was subsequently given. S100B immunoradiometric assay (IRMA) tests were performed before, during and after treatment at scheduled time points. In the interim analysis at 4 weeks 29 of 37 (78%) patients with tumour progression during treatment showed a raised S100B level. In the final analysis at 8 weeks, 31 of these 37 patients (84%) demonstrated rising S100B values (P < 0.001). Patients who responded to treatment (stable or regressing metastatic disease) showed constant or declining S100B levels in 38 of 40 patients (95%) at the interim analysis, at 8 weeks this was further increased to 39 of 40 patients (98%; P < 0.001). Thus, the use of S100B for monitoring treatment is adequate in the majority of cases. Our observations are of great interest for therapeutic trials of adjuvant and palliative therapies as the rise of S100B levels might indicate that re-staging and/or changes in therapy strategies should be chosen.
在恶性黑色素瘤的免疫组织学中，使用抗蛋白S100的多克隆抗体已得到充分确立。最近研究表明，S100蛋白家族的一个亚基S100B在黑色素瘤患者血清中可检测到，并且与转移性黑色素瘤患者的疾病分期相关。在本研究中，首次对64例不同患者在晚期转移性黑色素瘤（IV期）化疗和/或免疫治疗期间的大量治疗观察结果（n = 77）进行了评估。所有患者均按照标准化方案接受治疗，包括8周的治疗，随后进行常规分期程序以评估治疗效果。13例一线治疗后肿瘤增大的患者随后接受了二线治疗。在治疗前、治疗期间和治疗后的预定时间点进行S100B免疫放射分析（IRMA）检测。在4周的中期分析中，37例治疗期间肿瘤进展的患者中有29例（78%）S100B水平升高。在8周的最终分析中，这37例患者中有31例（84%）S100B值升高（P < 0.001）。对治疗有反应（转移性疾病稳定或消退）的患者在中期分析时，40例患者中有38例（95%）S100B水平保持不变或下降，在8周时这一比例进一步增至40例患者中的39例（98%；P < 0.001）。因此，在大多数情况下，使用S100B监测治疗是合适的。我们的观察结果对于辅助治疗和姑息治疗的试验具有重要意义，因为S100B水平的升高可能表明应选择重新分期和/或改变治疗策略。
