Evaluation of 5-S-cysteinyldopa as a marker of melanoma progression: 10 years' experience.
5-S-Cysteinyldopa (5-S-CD) has been used as a biochemical marker of melanoma progression. In this study, we measured serum levels of 5-S-CD in 2648 samples taken from 218 patients in order to evaluate the usefulness of this parameter in following melanoma progression and prognosis. 5-S-CD levels were significantly elevated above the upper limit of the normal range (10 nmol/l) in stage IV melanoma patients. The sensitivity of elevated serum 5-S-CD levels in detecting distant metastasis was 73%, while the specificity was 98% and the positive predictive value 94%. The sensitivity was improved to 77% when cases of amelanotic melanoma were excluded. Patients without metastases had elevated 5-S-CD values in 5% of the 1480 serum samples. Changes in serum 5-S-CD levels were followed during disease progression until the end stage in 49 patients. In 33% of the patients, elevation of serum 5-S-CD levels preceded clinical detection of visceral metastases, and in 37% elevation of 5-S-CD levels occurred at the same time as visceral metastasis. Patients with elevated 5-S-CD levels before or after surgical treatment had significantly shorter survival times than those with normal levels. These results show that the level of 5-S-CD in the serum is a sensitive and specific marker in predicting distant metastases. Elevated serum levels of 5-S-CD, before or after surgical treatment, is associated with a poor prognosis.
Fujita Health University School of Health Sciences, Toyoake, Aichi 470-1192, Japan.
K
K
Wakamatsu
T
T
Kageshita
M
M
Furue
N
N
Hatta
Y
Y
Kiyohara
J
J
Nakayama
T
T
Ono
T
T
Saida
M
M
Takata
T
T
Tsuchida
H
H
Uhara
A
A
Yamamoto
N
N
Yamazaki
A
A
Naito
S
S
Ito
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002648:Child; D003548:Cysteinyldopa / Q000097:blood*; D018450:Disease Progression; D005134:Eye Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D015993:Life Tables; D008297:Male; D008545:Melanoma / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016019:Survival Analysis
D014408:Biomarkers, Tumor; D003548:Cysteinyldopa