Voit Christiane, Kron Martina, Rademaker Juergen, Schwürzer-Voit Markus, Sterry Wolfram, Weber Lutz, Ozdemir Cueneyt, Proebstle Thomas, Keilholz Ulrich
Department of Dermatology of the Charité, Humboldt University, Schumannstr 20/21, 10117 Berlin, Germany.
J Clin Oncol. 2005 Feb 20;23(6):1218-27. doi: 10.1200/JCO.2005.04.098.
To assess the prognostic value of serial reverse transcriptase polymerase chain reaction (RT-PCR) -based measurements of tyrosinase mRNA in peripheral blood of stage II and III melanoma patients.
During routine follow-up of American Joint Committee on Cancer stage II and III melanoma patients, serial testing for tyrosinase transcripts in peripheral blood was performed by RT-PCR. The PCR results were compared with the clinical data collected during the follow-up.
Over a period of 3 years, 111 patients (78 stage II and 33 stage III patients) were enrolled, and tyrosinase determinations were carried out. The 6-year disease-specific survival probability was 97% for patients always showing negative RT-PCR results and 67% for patients who tested positive at least once. In a Cox proportional hazards model, the prognostic value of sex, age, site of primary tumor, histologic subtype, stage, Breslow's tumor thickness, Clark level, and the time-dependent variable PCR result was assessed. Patients with a positive RT-PCR test had a distinctly higher risk of dying from melanoma, with a hazard ratio of 12.6 (95% CI, 3.4 to 46.3; P < .001).
Our study shows a strong association between PCR and disease-specific survival time. Detection of tyrosinase mRNA in peripheral blood may be of similar importance for the clinical course of melanoma as the detection of micrometastatic disease in the sentinel lymph node. Whether a combination of these two factors leads to a better definition of the prognosis of melanoma patients is under investigation in current studies.
评估基于逆转录聚合酶链反应（RT-PCR）对II期和III期黑色素瘤患者外周血中酪氨酸酶mRNA进行系列检测的预后价值。
在美国癌症联合委员会II期和III期黑色素瘤患者的常规随访期间，通过RT-PCR对外周血中的酪氨酸酶转录本进行系列检测。将PCR结果与随访期间收集的临床数据进行比较。
在3年期间，共纳入111例患者（78例II期患者和33例III期患者）并进行了酪氨酸酶检测。RT-PCR结果始终为阴性的患者6年疾病特异性生存概率为97%，至少有一次检测呈阳性的患者为67%。在Cox比例风险模型中，评估了性别、年龄、原发肿瘤部位、组织学亚型、分期、Breslow肿瘤厚度、Clark分级以及随时间变化的变量PCR结果的预后价值。RT-PCR检测呈阳性的患者死于黑色素瘤的风险明显更高，风险比为12.6（95%CI，3.4至46.3；P<.001）。
我们的研究表明PCR与疾病特异性生存时间之间存在密切关联。外周血中酪氨酸酶mRNA的检测对于黑色素瘤临床病程的重要性可能与前哨淋巴结中微转移疾病的检测相似。目前的研究正在探讨这两个因素的组合是否能更好地定义黑色素瘤患者的预后。
