Egberts Friederike, Pollex Andrea, Egberts Jan-Hendrik, Kaehler Katharina C, Weichenthal Michael, Hauschild Axel
Department of Dermatology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany.
Onkologie. 2008 Jul;31(7):380-4. doi: 10.1159/000135492. Epub 2008 Jun 18.
The prognosis of metastatic melanoma is poor. The purpose of this study was to perform a long-term survival analysis on patients with advanced melanoma to determine clinical and laboratory prognostic factors for treatment outcome and long-term survival. The prognostic importance of S100B serum levels on overall survival compared to lactate dehydrogenase (LDH) was evaluated.
The medical records of 105 AJCC (American Joint Committee on Cancer) stage IV melanoma patients from 1994 to 2001 were analyzed retrospectively. Median time to progression and overall survival were assessed. Univariate and multivariate analysis were performed to determine prognostic factors.
86 (81.9%) of the 105 patients died during the observation period. In univariate analysis, pre-therapeutic LDH and S100B levels in serum samples (p = 0.01 and p = 0.002, respectively), tumor stage (AJCC IVa-IVc, p = 0.005), and response to the firstline therapy (p < 0.001) were found to be significant prognostic markers. However, in the multivariate analysis, pre-therapeutic S100B serum levels (p = 0.005, odds ratio (OR): 2.22, confidence interval (CI): 1.22-4.1) as well as presence of brain metastases (p = 0.009, OR: 5.08, CI: 1.51-17.05) were the only independent prognostic factors for overall survival.
In metastatic melanoma, S100B is a strong prognostic factor for overall and long-term survival, and superior to LDH.
转移性黑色素瘤的预后较差。本研究的目的是对晚期黑色素瘤患者进行长期生存分析，以确定治疗结果和长期生存的临床及实验室预后因素。评估了与乳酸脱氢酶（LDH）相比，S100B血清水平对总生存的预后重要性。
回顾性分析了1994年至2001年期间105例美国癌症联合委员会（AJCC）IV期黑色素瘤患者的病历。评估了疾病进展的中位时间和总生存期。进行单因素和多因素分析以确定预后因素。
105例患者中有86例（81.9%）在观察期内死亡。在单因素分析中，血清样本中的治疗前LDH和S100B水平（分别为p = 0.01和p = 0.002）、肿瘤分期（AJCC IVa-IVc，p = 0.005）以及对一线治疗的反应（p < 0.001）被发现是显著的预后标志物。然而，在多因素分析中，治疗前S100B血清水平（p = 0.005，比值比（OR）：2.22，置信区间（CI）：1.22 - 4.1）以及脑转移的存在（p = 0.009，OR：5.08，CI：1.51 - 17.05）是总生存的唯一独立预后因素。
在转移性黑色素瘤中，S100B是总生存和长期生存的强有力预后因素，且优于LDH。
