De Giorgi Vincenzo, Pinzani Pamela, Salvianti Francesca, Grazzini Marta, Orlando Claudio, Lotti Torello, Pazzagli Mario, Massi Daniela
Department of Dermatology, University of Florence, Via della Pergola 60, 50132 Florence, Italy.
Arch Dermatol. 2010 Oct;146(10):1120-4. doi: 10.1001/archdermatol.2010.264.
The notion that only malignant melanoma cells circulate and diffuse is shared by oncologists and pathologists. Isolation by size of epithelial tumor cells (ISET) allows the identification of circulating tumor cells by filtration according to size.
During a study of identification of circulating melanoma cells using ISET, blood samples from a 69-year-old man with an atypical melanocytic lesion on his back were evaluated. Binucleated and multinucleated cells that fulfilled the criteria for circulating tumor cells were found. The morphological features were similar to those of the excised skin tissue specimen, and the patient was subsequently diagnosed as having a congenital melanocytic nevus. BRAF (V600E)-mutated DNA was detected in both plasma and formalin-fixed tissue specimens, and the blood samples demonstrated an increase in tyrosinase messenger RNA levels.
The finding that benign nevus cells may circulate in blood brings into question the value of tyrosinase or other melanocytic markers as a molecular surrogate for circulating melanoma cells.
肿瘤学家和病理学家都认为只有恶性黑色素瘤细胞会循环和扩散。上皮肿瘤细胞大小分离法（ISET）可通过按大小过滤来识别循环肿瘤细胞。
在一项使用ISET识别循环黑色素瘤细胞的研究中，对一名69岁背部有非典型黑素细胞病变男性的血样进行了评估。发现了符合循环肿瘤细胞标准的双核和多核细胞。其形态特征与切除的皮肤组织标本相似，该患者随后被诊断为先天性黑素细胞痣。在血浆和福尔马林固定的组织标本中均检测到BRAF（V600E）突变的DNA，血样中酪氨酸酶信使RNA水平升高。
良性痣细胞可能在血液中循环这一发现，使酪氨酸酶或其他黑素细胞标志物作为循环黑色素瘤细胞分子替代物的价值受到质疑。
