title: Visualization of circulating melanoma cells in peripheral blood of patients with primary uveal melanoma.
abstract: OBJECTIVE
  In patients with uveal melanoma, tumor cell dissemination and subsequent formation of metastases are confined mainly to the hematogenous route. Here, we sought to isolate circulating melanoma cells in peripheral blood of patients with primary uveal melanoma and clinically localized disease.
  
  
  METHODS
  Blood samples from 52 patients with clinically localized uveal melanoma and from 20 control individuals were prospectively collected before therapy of the primary tumor. Tumor cells expressing the melanoma-associated chondroitin sulfate proteoglycan were enriched by immunomagnetic cell sorting and visualized by immunocytologic staining. Results were compared with clinical data at presentation.
  
  
  RESULTS
  In 10 of 52 patients [19%; 95% confidence interval (95% CI), 10-33%], between 1 and 5 circulating melanoma cells were detected in 50 mL peripheral blood. No melanoma-associated chondroitin sulfate proteoglycan-positive cells were detected in any of the 20 controls examined. The presence of tumor cells in peripheral blood was associated with ciliary body invasion [odds ratio (OR), 20.0; 95% CI, 3.0-131.7], advanced local tumor stage (OR, 6.7; 95% CI, 1.8-25.4), and anterior tumor localization (OR, 4.0; 95% CI, 1.2-12.7), all established factors for uveal melanoma progression.
  
  
  CONCLUSIONS
  Immunomagnetic enrichment enables detection of intact melanoma cells in peripheral blood of patients with clinically localized ocular disease. Visualization and capturing of these cells provide a unique tool for characterizing potentially metastasizing tumor cells from a primary melanoma at an early stage of the disease.
authors.affiliation: Department of Dermatology and University Eye Hospital, Centre for Ophthalmology, Eberhard Karls University of Tuebingen, Tuebingen, Germany. anja.ulmer@med.uni.tuebingen.de
authors.forename: Anja
authors.initials: A
authors.lastname: Ulmer
authors.forename: Julia
authors.initials: J
authors.lastname: Beutel
authors.forename: Daniela
authors.initials: D
authors.lastname: Süsskind
authors.forename: Ralf-Dieter
authors.initials: RD
authors.lastname: Hilgers
authors.forename: Focke
authors.initials: F
authors.lastname: Ziemssen
authors.forename: Matthias
authors.initials: M
authors.lastname: Lüke
authors.forename: Martin
authors.initials: M
authors.lastname: Röcken
authors.forename: Martin
authors.initials: M
authors.lastname: Rohrbach
authors.forename: Gerhard
authors.initials: G
authors.lastname: Fierlbeck
authors.forename: Karl-Ulrich
authors.initials: KU
authors.lastname: Bartz-Schmidt
authors.forename: Salvatore
authors.initials: S
authors.lastname: Grisanti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D018189:Immunomagnetic Separation; D008297:Male; D008545:Melanoma / Q000097:blood* / Q000473:pathology*; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D014604:Uveal Neoplasms / Q000097:blood* / Q000473:pathology*