Baldi A, Dragonetti E, Battista T, Groeger A M, Esposito V, Baldi G, Santini D
Laboratory for Cell Metabolism and Pharmacokinetics, Center for Experimental Research, Regina Elena Cancer Institute, Rome, Italy.
Anticancer Res. 2000 Sep-Oct;20(5C):3923-8.
Recently, reverse transcriptase-polymerase chain reaction (RT-PCR) for the detection of circulating tumor cells has been suggested as a potential technique for staging cancer. In this report, 43 melanoma patients (including 4 in situ melanoma patients) were tested for tyrosinase mRNA in blood by RT-PCR. All patients had melanoma thinner than 1.5 mm (stage I). Circulating melanoma cells were detected in 8 (18.6%) out of 43 MM patients tested: 5 (16.1%) of 31 patients with melanoma thinner than 0.76 mm and 3 (42.8%) out of 7 patients with melanoma thicker than 0.76 mm. Moreover, in the tyrosinase-negative group we found only 4/31 patients (13%) with histologic signs of regression, but in the tyrosinase-positive group, 3 out of 8 patients (37.5%) showed, at histologic examination, signs of regression. At the time of this analysis all the patients enrolled (tyrosinase-negative and tyrosinase-positive ones) were free of disease, probably due to the short median time of follow-up after the inclusion in the study. The presence of regression is an important cause of melanoma understaging and the tyrosinase test could represent an effective tool in order to achieve a realistic staging in this subgroup of melanoma patients. Probably, maximum sensitivity of the diagnostic RT-PCR approach to monitor MM patients with either localized or advanced disease could be achieved by using additional markers expressed with high frequencies in melanoma. We propose that one such marker could be the sign of regression.
最近，用于检测循环肿瘤细胞的逆转录酶-聚合酶链反应（RT-PCR）已被认为是一种潜在的癌症分期技术。在本报告中，对43例黑色素瘤患者（包括4例原位黑色素瘤患者）进行了RT-PCR检测血液中的酪氨酸酶mRNA。所有患者的黑色素瘤厚度均小于1.5mm（I期）。在43例接受检测的黑色素瘤患者中，有8例（18.6%）检测到循环黑色素瘤细胞：在31例厚度小于0.76mm的黑色素瘤患者中有5例（16.1%），在7例厚度大于0.76mm的黑色素瘤患者中有3例（42.8%）。此外，在酪氨酸酶阴性组中，我们仅发现4/31例患者（13%）有组织学消退迹象，但在酪氨酸酶阳性组中，8例患者中有3例（37.5%）在组织学检查时显示有消退迹象。在本次分析时，所有纳入研究的患者（酪氨酸酶阴性和阳性患者）均无疾病，这可能是由于纳入研究后的随访中位时间较短。消退的存在是黑色素瘤分期不足的一个重要原因，而酪氨酸酶检测可能是在这一亚组黑色素瘤患者中实现实际分期的有效工具。可能通过使用在黑色素瘤中高频率表达的其他标志物，可实现诊断性RT-PCR方法监测局限性或晚期黑色素瘤患者的最大敏感性。我们认为这样一种标志物可能是消退迹象。
