Bánfalvi T, Udvarhelyi N, Orosz Z, Gergye M, Gilde K, Tímár J
Department of Dermatology, National Institute of Oncology, Budapest, Hungary.
Oncology. 2003;64(4):374-9. doi: 10.1159/000070296.
Serum S-100B is a reliable tumor marker of malignant melanoma, but efficient use is restricted to patients with metastatic disease. Therefore, the aim of our study was to assess serum S-100B levels at different stages of malignant melanoma and to compare these levels with the expression of the S-100B phenotype in primary tumors and lymph node metastases.
Fifty-nine patients were included in this study; serum S-100B protein was measured using an immunoluminometric assay while the expression pattern in the primary tumor was determined by immunohistochemistry using an anti-S-100B monoclonal antibody.
Serum S-100B concentrations were significantly elevated in stage III (p = 0.01) patients, with normal levels in stage I-II. The most frequent S-100B protein expression pattern of the melanoma tissue was found to be diffuse staining observed in around half of the cases (52.5%) followed by heterogeneous (30.5%) and focal patterns (17%), being independent of the stage as well as the lymph node involvement. In stage I-II patients, the various staining patterns did not correlate with the serum concentration of the S-100B protein, while in stage III patients with heterogenous or diffuse S-100B staining patterns in tumor tissue, the serum marker concentration was significantly higher (p < 0.05) than in patients with focal staining. Furthermore, S-100B staining of the melanoma tissue also differed (low/negative, medium and strong staining), and serum marker concentrations corresponded to the pattern of the staining intensity. In stage I-II, only strong staining was associated with elevated serum S-100B concentrations while in stage III medium and strong staining was found to be associated with significantly higher serum marker concentrations compared to patients with tumors with low/negative staining (p < 0.05).
In malignant melanoma characterized by focal and/or low S-100B staining in the tumor tissue determined by immunohistochemistry, S-100B monitoring in the serum may not suffice to detect disease progression.
血清S-100B是恶性黑色素瘤可靠的肿瘤标志物，但仅在转移性疾病患者中能有效应用。因此，本研究旨在评估恶性黑色素瘤不同阶段的血清S-100B水平，并将这些水平与原发性肿瘤及淋巴结转移灶中S-100B表型的表达进行比较。
本研究纳入59例患者；采用免疫发光分析法检测血清S-100B蛋白，同时使用抗S-100B单克隆抗体通过免疫组织化学法确定原发性肿瘤中的表达模式。
III期患者血清S-100B浓度显著升高（p = 0.01），I-II期患者水平正常。黑色素瘤组织中最常见的S-100B蛋白表达模式为弥漫性染色，约半数病例（52.5%）出现，其次为异质性（30.5%）和局灶性模式（17%），与分期及淋巴结受累情况无关。在I-II期患者中，不同染色模式与S-100B蛋白血清浓度无关，而在肿瘤组织中具有异质性或弥漫性S-100B染色模式的III期患者中，血清标志物浓度显著高于局灶性染色患者（p < 0.05）。此外，黑色素瘤组织的S-100B染色也有所不同（低/阴性、中等和强染色），血清标志物浓度与染色强度模式相对应。在I-II期，只有强染色与血清S-100B浓度升高有关，而在III期，与低/阴性染色肿瘤患者相比，中等和强染色与显著更高的血清标志物浓度有关（p < 0.05）。
在免疫组织化学确定肿瘤组织中存在局灶性和/或低S-100B染色的恶性黑色素瘤中，监测血清S-100B可能不足以检测疾病进展。
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