Division of Surgical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Ann Surg Oncol. 2009 Dec;16(12):3455-62. doi: 10.1245/s10434-009-0629-8.
Elevation of the tumor marker S-100B in melanoma patients is a highly specific indicator of recurrence.
The role of S-100B in disease-free survival (DFS) was evaluated in stage III melanoma patients (staged with fluorodeoxyglucose positron emission tomography [FDG-PET] and computed tomography [CT]) with palpable lymph node metastases who underwent therapeutic lymph node dissection. S-100B and LDH were measured on the day before surgery (d = -1) and on days 1, 2, and 7 postoperatively. Multivariate logistic regression was used to study factors associated with preoperative elevation of S-100B. Univariate (log-rank test) and multivariate (Cox regression) survival analyses were performed to identify factors associated with DFS.
Between 2004 and 2008, 56 patients (median age 57, range 24-93) years, 27 males (48%) and 29 females (52%) entered the study. Preoperative S-100B elevation was found in 27 patients (48%) and elevated LDH in 20 patients (36%). No association was found between these two markers at any time. Multivariate analysis showed that elevated S-100B preoperatively (hazard ratio [HR] 2.7, P = .03) was associated with DFS. S-100B elevation was associated with increased tumor size (odds ratio [OR] 3.40; P = .03).
Elevated S-100B preoperatively in patients with optimally staged clinical stage III melanoma is associated with decreased disease-free survival. S100-B could be used as a prognostic marker in the stratification of new adjuvant trials to select stage III melanoma patients for adjuvant systematic treatment.
黑色素瘤患者肿瘤标志物 S-100B 升高是复发的高度特异性指标。
对行淋巴结清扫术的可触及淋巴结转移的 III 期黑色素瘤患者（通过氟脱氧葡萄糖正电子发射断层扫描 [FDG-PET] 和计算机断层扫描 [CT] 分期）进行 S-100B 在无病生存（DFS）中的作用评估。在手术前一天（d=-1）以及术后第 1、2 和 7 天测量 S-100B 和乳酸脱氢酶（LDH）。使用多变量逻辑回归研究与术前 S-100B 升高相关的因素。进行单变量（对数秩检验）和多变量（Cox 回归）生存分析，以确定与 DFS 相关的因素。
2004 年至 2008 年间，56 例患者（中位年龄 57 岁，范围 24-93 岁）入组，男性 27 例（48%），女性 29 例（52%）。术前 27 例（48%）患者 S-100B 升高，20 例（36%）患者 LDH 升高。在任何时间都未发现这两种标志物之间存在关联。多变量分析显示，术前 S-100B 升高（风险比 [HR] 2.7，P=.03）与 DFS 相关。S-100B 升高与肿瘤体积增大相关（优势比 [OR] 3.40；P=.03）。
最佳分期的 III 期黑色素瘤患者术前 S-100B 升高与无病生存降低相关。S100-B 可作为新辅助试验分层的预后标志物，以选择 III 期黑色素瘤患者接受辅助系统性治疗。
