Department of Dermatology, New York University School of Medicine, New York, NY, USA.
J Transl Med. 2010 Feb 23;8:19. doi: 10.1186/1479-5876-8-19.
Increased levels of cryptic collagen epitope HU177 in the sera of melanoma patients have been shown to be associated with thicker primary melanomas and with the nodular histologic subtype. In this study, we investigate the association between HU177 shedding in the sera and clinical outcome in terms of disease-free survival (DFS) and overall survival (OS).
Serum samples from 209 patients with primary melanoma prospectively enrolled in the Interdisciplinary Melanoma Cooperative Group at the New York University Langone Medical Center (mean age = 58, mean thickness = 2.09 mm, stage I = 136, stage II = 41, stage III = 32, median follow-up = 54.9 months) were analyzed for HU177 concentration using a validated ELISA assay. HU177 serum levels at the time of diagnosis were used to divide the study cohort into two groups: low and high HU177. DFS and OS were estimated by Kaplan-Meier survival analysis, and the log-rank test was used to compare DFS and OS between the two HU177 groups. Multivariate Cox proportional hazards regression models were employed to examine the independent effect of HU177 category on DFS and OS.
HU177 sera concentrations ranged from 0-139.8 ng/ml (mean and median of 6.2 ng/ml and 3.7 ng/ml, respectively). Thirty-eight of the 209 (18%) patients developed recurrences, and 34 of the 209 (16%) patients died during follow-up. Higher HU177 serum level was associated with an increased rate of melanoma recurrence (p = 0.04) and with increasing mortality (p = 0.01). The association with overall survival remained statistically significant after controlling for thickness and histologic subtype in a multivariate model (p = 0.035).
Increased shedding of HU177 in the serum of primary melanoma patients is associated with poor prognosis. Further studies are warranted to determine the clinical utility of HU177 in risk stratification compared to the current standard of care.
已证实，黑色素瘤患者血清中隐蔽性胶原蛋白表位 HU177 水平升高与原发性黑色素瘤厚度增加及结节性组织学亚型相关。本研究旨在通过无病生存（DFS）和总生存（OS）评估 HU177 血清脱落与临床结局的相关性。
前瞻性纳入纽约大学朗格尼医学中心（NYU Langone Medical Center）多学科黑色素瘤合作组（Interdisciplinary Melanoma Cooperative Group）的 209 例原发性黑色素瘤患者的血清样本（平均年龄 58 岁，平均厚度 2.09mm，I 期 136 例，II 期 41 例，III 期 32 例，中位随访时间 54.9 个月），使用经验证的 ELISA 检测试剂盒分析 HU177 浓度。根据诊断时 HU177 血清水平将研究队列分为低 HU177 组和高 HU177 组。通过 Kaplan-Meier 生存分析估计 DFS 和 OS，采用对数秩检验比较两组 HU177 间的 DFS 和 OS。采用多因素 Cox 比例风险回归模型分析 HU177 类别对 DFS 和 OS 的独立影响。
HU177 血清浓度范围为 0-139.8ng/ml（平均值和中位数分别为 6.2ng/ml 和 3.7ng/ml）。209 例患者中 38 例（18%）复发，34 例（16%）死亡。较高的 HU177 血清水平与黑色素瘤复发率增加相关（p=0.04），且与死亡率增加相关（p=0.01）。在多因素模型中，控制厚度和组织学亚型后，HU177 与总生存的相关性仍具有统计学意义（p=0.035）。
原发性黑色素瘤患者血清中 HU177 脱落增加与预后不良相关。需要进一步研究以确定 HU177 在风险分层方面与当前标准治疗相比的临床应用价值。
