School of Medical Sciences, Edith Cowan University, Perth, WA, Australia.
Br J Dermatol. 2013 Jan;168(1):85-92. doi: 10.1111/bjd.12057. Epub 2012 Nov 15.
Multimarker quantitative real-time polymerase chain reaction (qRT-PCR) represents an effective method for detecting circulating tumour cells in the peripheral blood of patients with melanoma.
To investigate whether the phenotype of circulating melanoma cells represents a useful indicator of disease stage, recurrence and treatment efficacy.
Peripheral blood was collected from 230 patients with melanoma and 152 healthy controls over a period of 3years and 9months. Clinical data and blood samples were collected from patients with primary melanoma (early stages, 0-II, n=154) and metastatic melanoma (late stages, III-IV, n=76). Each specimen was examined by qRT-PCR analysis for the expression of five markers: MLANA, ABCB5, TGFβ2, PAX3d and MCAM.
In total, 212 of the patients with melanoma (92%) expressed markers in their peripheral blood. Two markers, MLANA and ABCB5, had the greatest prognostic value, and were identified as statistically significant among patients who experienced disease recurrence within our study period, being expressed in 45% (MLANA) and 49% (ABCB5) of patients with recurrence (P=0·001 and P=0·031, respectively). For patients administered nonsurgical treatments, MCAM expression correlated with poor treatment outcome.
Circulating tumour cells were detectable at all stages of disease and long after surgical treatment, even when patients were considered disease free. Specifically, expression of ABCB5 and MLANA had significant prognostic value in inferring disease recurrence, while MCAM expression was associated with poor patient outcome after treatment, confirming multimarker qRT-PCR as a potential technique for monitoring disease status.
多标志物实时定量聚合酶链反应（qRT-PCR）是一种检测黑色素瘤患者外周血循环肿瘤细胞的有效方法。
探讨循环黑素瘤细胞的表型是否代表疾病分期、复发和治疗效果的有用指标。
在 3 年 9 个月的时间里，采集了 230 名黑色素瘤患者和 152 名健康对照者的外周血。采集了原发性黑色素瘤（早期，0-II 期，n=154）和转移性黑色素瘤（晚期，III-IV 期，n=76）患者的临床数据和血液样本。通过 qRT-PCR 分析，对 5 种标志物（MLANA、ABCB5、TGFβ2、PAX3d 和 MCAM）在每个标本中的表达进行了检测。
共有 212 名黑色素瘤患者（92%）在其外周血中表达了标志物。两种标志物 MLANA 和 ABCB5 具有最大的预后价值，在本研究期间经历疾病复发的患者中被认为具有统计学意义，在复发患者中表达分别为 45%（MLANA）和 49%（ABCB5）（P=0·001 和 P=0·031）。对于接受非手术治疗的患者，MCAM 表达与治疗效果差相关。
循环肿瘤细胞在疾病的所有阶段和手术治疗后很长时间都可检测到，即使患者被认为无疾病。具体来说，ABCB5 和 MLANA 的表达对推断疾病复发具有显著的预后价值，而 MCAM 的表达与治疗后患者的不良预后相关，证实了多标志物 qRT-PCR 作为监测疾病状态的潜在技术。
