Optimization of the tyrosinase mRNA probe to detect circulating melanocytes with reverse transcription and polymerase chain reaction.

It was recently suggested that reverse transcription polymerase chain reaction (RT-PCR)-based detection of tyrosinase messenger RNA (mRNA) in peripheral blood is useful in the early detection of circulating tumor cells, since tyrosinase is thought to be a melanocyte-specific marker. However, the sensitivity of detection of these cells in circulation is controversial, some authors reporting 0% effectiveness, others obtaining 100% efficacy. We developed a modification of a technique to process blood samples to detect tyrosinase mRNA, and tested the method with 50 samples from as many patients with histologically confirmed malignant melanoma in different stages. Whole blood was processed by discarding the plasma and extracting RNA from density gradient-isolated peripheral blood lymphocytes. The RNA samples were tested with a sensitive nested primer RT-PCR assay. Sensitivity was tested using RNA extracted from SK-mel-1 human melanoma cells diluted serially with peripheral blood obtained from healthy control subjects. A lymph node from a patient with confirmed disseminated melanoma served as the positive control. Our technique was able to detect tyrosinase mRNA in samples from the 37 patients with progressive metastatic melanoma. The test detected tyrosinase mRNA from both the melanoma cell line and the positive lymph node. Our method to extract RNA from whole blood improves the specificity and sensitivity of tyrosinase mRNA detection by RT-PCR. The test should be of use in determining the prognosis of patients with melanoma, and in deciding when to initiate early treatment in patients with malignant melanoma.