Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
J Invest Dermatol. 2013 Jun;133(6):1460-2. doi: 10.1038/jid.2013.34.
The prognosis of patients with metastatic melanoma has improved significantly with targeted therapeutic agents and immunotherapies. Detection of early melanoma recurrence after treatment will be beneficial to switch patients who fail on one therapy to different modalities. Circulating tumor cells (CTCs) are cancer cells released by a tumor into the peripheral blood. These cells hold potential as prognostic, predictive, and pharmacodynamic biomarkers for treatment. In this issue, Khoja et al. report that melanoma CTCs can be detected using Melcam and high molecular weight melanoma-associated antibody. They found that in 101 stage IV melanoma patients, CTC numbers ranged between 0 and 36/7.5 ml blood; 26% of the patients had ≥ 2 CTCs at baseline. The CTC number (≥ 2 CTCs) at baseline was significantly prognostic for median overall survival (OS) in univariate and multivariate analysis. Patients receiving treatment where CTC numbers remained ≥ 2 CTCs during their treatment had shorter median OS than those who maintained <2 CTCs (7 vs. 10 months, hazard ratio 0.34, 95% confidence interval 0.14-0.81, log-rank test P=0.015). The implications of this work are substantial in counseling patients about their prognosis and in helping to assess responses to systemic therapies.
转移性黑色素瘤患者的预后已通过靶向治疗药物和免疫疗法得到显著改善。在治疗后检测早期黑色素瘤复发将有助于将对一种治疗方法无效的患者转换为不同的治疗方式。循环肿瘤细胞（CTC）是肿瘤释放到外周血中的癌细胞。这些细胞具有作为预后、预测和治疗药效学生物标志物的潜力。在本期杂志中，Khoja 等人报告说，可以使用 Melcam 和高分子量黑色素瘤相关抗体来检测黑色素瘤 CTC。他们发现，在 101 例 IV 期黑色素瘤患者中，CTC 数量范围为 0 至 36/7.5ml 血液；26%的患者在基线时有≥2 个 CTC。在单因素和多因素分析中，基线时 CTC 数量（≥2 个 CTC）对中位总生存期（OS）具有显著的预后意义。在治疗过程中 CTC 数量持续≥2 个 CTC 的患者的中位 OS 短于那些 CTC 数量保持<2 个 CTC 的患者（7 个月与 10 个月，风险比 0.34，95%置信区间 0.14-0.81，对数秩检验 P=0.015）。这项工作的意义在于为患者提供预后咨询，并帮助评估对系统治疗的反应。
