Barak Vivian, Kaiserman Igor, Frenkel Shahar, Hendler Keren, Kalickman Inna, Pe'er Jacob
Immunology Laboratory for Tumor Diagnosis, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Anticancer Res. 2011 Jan;31(1):345-9.
To examine the kinetics of the tumor marker levels: osteopontin (OPN), S-100β, melanoma inhibitory activity (MIA) and tissue polypeptide-specific antigen (TPS), and to evaluate their potential for predicting earlier liver metastasis in patients with uveal melanoma (UM).
Forty-three UM patients who remained disease-free (DF) for at least 10 years, 32 patients with metastatic UM and 53 healthy controls were enrolled. Median and mean levels of the tumor markers OPN, S-100β, MIA and TPS at the time periods of 0-6, 6-12, 12-18, 18-24 and >24 months prior to confirmation of metastasis by liver ultrasound, CT scan and biopsy, served in a box and whiskers analysis and were compared by Students t-test. Trends of changes in marker levels of DF and metastatic UM groups were calculated and compared by ANOVA.
The lead-time for predicting metastasis was: 12-18 months both for OPN (p=0.005) and MIA (p=0.37), for S-100β 18-24 months first increase (p=0.5) followed by a second one 0-6 months (p=0.01) and for TPS 18-24 months (p=0.1). The gradient of the trendlines for the metastatic group was significantly steeper for MIA (p=0.02) and S-100β (p=0.018) than for the DF group and not statistically significant for OPN (p=0.168). For TPS, the trendline was negative. The overall increase in the levels of OPN and S-100β was significant, while for TPS and MIA, it was not.
Significant increases in OPN and S-100β levels were demonstrated by a major lead time. Trendlines of the metastasis group were steeper than of the DF group predicting liver metastasis. The routine use of those markers in the follow up of UM patients, can enable earlier diagnosis of liver metastasis and effective therapeutic intervention, with an impact on survival.
研究肿瘤标志物骨桥蛋白（OPN）、S-100β、黑色素瘤抑制活性因子（MIA）和组织多肽特异性抗原（TPS）水平的动力学变化，并评估它们在预测葡萄膜黑色素瘤（UM）患者早期肝转移方面的潜力。
纳入43例无病生存至少10年的UM患者、32例转移性UM患者和53例健康对照者。在通过肝脏超声、CT扫描和活检确认转移前0至6个月、6至12个月、12至18个月、18至24个月及>24个月期间，对肿瘤标志物OPN、S-100β、MIA和TPS的中位数和平均水平进行箱线图分析，并采用学生t检验进行比较。计算并通过方差分析比较无病和转移性UM组标志物水平的变化趋势。
预测转移的提前期为：OPN（p=0.005）和MIA（p=0.37）均为12至18个月，S-100β在18至24个月首次升高（p=0.5），随后在0至6个月再次升高（p=0.01），TPS为18至24个月（p=0.1）。转移性组MIA（p=0.02）和S-100β（p=0.018）趋势线的斜率显著高于无病组，OPN（p=0.168）无统计学意义。TPS的趋势线为负。OPN和S-100β水平总体升高显著，而TPS和MIA则不然。
OPN和S-100β水平在较长提前期内显著升高。转移组的趋势线比无病组更陡，可预测肝转移。在UM患者随访中常规使用这些标志物，能够实现肝转移的早期诊断和有效的治疗干预，从而影响生存。
