Diagnostic value and prognostic significance of protein S-100beta, melanoma-inhibitory activity, and tyrosinase/MART-1 reverse transcription-polymerase chain reaction in the follow-up of high-risk melanoma patients.

Abstract

BACKGROUND:

Cutaneous melanoma is the most aggressive form of skin carcinoma in humans, frequently with a rapid progression of disease. To detect early developing metastasis, laboratory tests to determine levels of lactate dehydrogenase (LDH) and alkaline phosphatase (AP) form part of the regular follow-up, but often cannot discover recurrent disease at a sufficiently early stage.

METHODS:

To evaluate the diagnostic accuracy of protein S-100beta (S-100beta), melanoma-inhibitory activity (MIA), LDH, AP, and tyrosinase/MART-1 reverse transcription-polymerase chain reaction (RT-PCR), the authors included 296 consecutive AJCC Stage II or III clinically disease-free melanoma patients. Follow-up examinations were performed every 3 months and blood samples were drawn to determine the levels of these tumor markers.

RESULTS:

Metastasis occurred in 41 of the 296 patients during a median follow-up period of 19 months (range, 1-33 months). The sensitivity to detect new metastases was 29% for protein S-100beta, 22% for MIA, 2% for LDH, 17% for AP, and 24% for RT-PCR. The diagnostic accuracy was best for MIA (86%) and S-100beta (84%), whereas AP (79%), LDH (77%), and RT-PCR (72%) demonstrated lower values. Elevated values of S-100beta and MIA during follow-up examinations were associated with decreased survival rates in the further course of the disease, but pathologic findings of the other tumor markers showed no prognostic impact.

CONCLUSIONS:

To the authors' knowledge, the current study is the first comparison of the diagnostic accuracy of currently available tumor markers in the follow-up of high-risk melanoma patients. Protein S-100beta and MIA demonstrated a higher sensitivity, specificity, and diagnostic accuracy in the diagnosis of newly occurring metastasis compared with to the tumor markers AP, LDH, and RT-PCR diagnostics. Therefore, the tumor markers S-100beta and MIA may be useful in the follow-up of disease-free Stage II and III melanoma patients.

• Authors: Claus Garbe, Ulrike Leiter, Ulf Ellwanger, Hans-Juergen Blaheta, Friedegund Meier, Gernot Rassner, Birgit Schittek
• Journal: Cancer (Cancer) Vol. 97 Issue 7 Pg. 1737-45 (Apr 01 2003) ISSN: 0008-543X [Print] United States
• PMID: 12655531 (Publication Type: Journal Article)
• Copyright: Copyright 2003 American Cancer Society.DOI 10.1002/cncr.11250

Chemical References

• Antigens, Neoplasm
• Biomarkers, Tumor
• Extracellular Matrix Proteins
• MART-1 Antigen
• MIA protein, human
• MLANA protein, human
• Neoplasm Proteins
• Nerve Growth Factors
• S100 Calcium Binding Protein beta Subunit
• S100 Proteins

Topics

• Adult
• Antigens, Neoplasm
• Biomarkers, Tumor (analysis)
• Extracellular Matrix Proteins
• Female
• Follow-Up Studies
• Humans
• MART-1 Antigen
• Male
• Melanoma (diagnosis)
• Middle Aged
• Neoplasm Metastasis (diagnosis)
• Neoplasm Proteins (analysis)
• Neoplasm Recurrence, Local (diagnosis)
• Nerve Growth Factors
• Prognosis
• Reverse Transcriptase Polymerase Chain Reaction
• Risk
• S100 Calcium Binding Protein beta Subunit
• S100 Proteins (analysis)
• Skin Neoplasms (diagnosis)
• Time Factors