Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany.
BMC Cancer. 2019 Mar 7;19(1):207. doi: 10.1186/s12885-019-5384-z.
The role of eosinophils in cancer is not yet completely understood, but patients with eosinophilia show a trend towards longer survival in several types of cancer, including melanoma. However, eosinophil count at initial diagnosis of metastatic melanoma does not predict survival. Since eosinophil cationic protein (ECP) mediates anticancer effects, such as tissue remodelling and cytotoxic activity, we investigated this marker as an early prognostic marker in metastatic melanoma.
Serum of 56 melanoma patients was collected at the time of diagnosis of metastatic disease. ECP levels as measured by ELISA were correlated with overall survival (OS) in patients before systemic therapy with immunotherapy or chemotherapy. Statistical analyses were performed using the Log-Rank (Mantel-Cox) test.
The median OS for patients with high serum ECP above 12.2 ng/ml was 12 months (n = 39), compared to 28 months for patients with ECP below this threshold (n = 17; p = 0.0642). In patients with cutaneous melanoma, excluding patients with uveal and mucosal melanoma, the survival difference was even more striking (p = 0.0393). ECP's effect size on OS was observed independently of the consecutive therapy. ECP levels were not correlated with LDH levels.
ECP seems to be a novel prognostic serum marker for the outcome of melanoma patients, which is independent of LDH and easy to perform in clinical practice. The striking negative prognostic value of high ECP level is unanticipated and can guide patient management.
嗜酸性粒细胞在癌症中的作用尚未完全阐明，但在包括黑色素瘤在内的几种癌症中，嗜酸性粒细胞增多的患者表现出生存时间延长的趋势。然而，转移性黑色素瘤初始诊断时的嗜酸性粒细胞计数并不能预测生存。由于嗜酸性粒细胞阳离子蛋白（ECP）介导抗肿瘤作用，如组织重塑和细胞毒性活性，我们研究了这种标志物作为转移性黑色素瘤的早期预后标志物。
在转移性疾病诊断时收集了 56 名黑色素瘤患者的血清。通过 ELISA 测量 ECP 水平，并与接受免疫治疗或化疗的系统性治疗前患者的总生存期（OS）相关联。使用对数秩（Mantel-Cox）检验进行统计分析。
血清 ECP 水平高于 12.2ng/ml 的患者中位 OS 为 12 个月（n=39），而 ECP 水平低于此阈值的患者中位 OS 为 28 个月（n=17；p=0.0642）。在皮肤黑色素瘤患者中，不包括葡萄膜和粘膜黑色素瘤患者，生存差异更为显著（p=0.0393）。ECP 对 OS 的影响大小独立于连续治疗。ECP 水平与 LDH 水平不相关。
ECP 似乎是黑色素瘤患者预后的一种新的血清标志物，独立于 LDH，易于在临床实践中进行。高 ECP 水平的显著负预后价值出乎意料，可以指导患者管理。
