Karjalainen J M
Department of Surgery, Kuopio University Hospital, PO Box 1777, FIN-70211 Kuopio, Finland.
Curr Oncol Rep. 2001 Jul;3(4):368-75. doi: 10.1007/s11912-001-0091-7.
Approximately one third of patients with cutaneous melanoma later develop a metastatic disease, having then an extremely poor rate of survival. Because of the highly unpredictable nature of melanomas, finding those patients who are likely to develop a metastatic disease and those patients who probably will survive is an ongoing challenge. The current "conventional" prognosticators, such as Breslow thickness, Clark level of invasion, and ulceration, cannot perfectly predict the clinical course of this disease at an individual level. Although the sentinel lymph node biopsy procedure and reverse transcription polymerase chain reaction techniques have significantly improved the staging of patients with melanoma, new molecular prognostic markers may help in selection of appropriate patients for strenuous adjuvant therapies and for randomized clinical trials. Furthermore, these markers also improve our basic understanding of the biology of cutaneous melanoma, potentially offering new targets for novel treatment strategies. This paper reviews the current literature on transcription factors and other dysregulated proteins involved in melanoma prognosis.
大约三分之一的皮肤黑色素瘤患者随后会发展为转移性疾病,其生存率极低。由于黑色素瘤具有高度不可预测的特性,找出那些可能发展为转移性疾病的患者以及那些可能存活的患者一直是一项挑战。当前的“传统”预后指标,如 Breslow 厚度、Clark 侵袭水平和溃疡情况,无法在个体层面完美预测这种疾病的临床进程。尽管前哨淋巴结活检程序和逆转录聚合酶链反应技术显著改善了黑色素瘤患者的分期,但新的分子预后标志物可能有助于选择适合进行强化辅助治疗和随机临床试验的患者。此外,这些标志物还能增进我们对皮肤黑色素瘤生物学的基本理解,有可能为新的治疗策略提供新靶点。本文综述了当前关于参与黑色素瘤预后的转录因子和其他失调蛋白的文献。