Visualization of circulating melanoma cells in peripheral blood of patients with primary uveal melanoma.
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.
Ulmer
Anja
A
Department of Dermatology and University Eye Hospital, Centre for Ophthalmology, Eberhard Karls University of Tuebingen, Tuebingen, Germany. anja.ulmer@med.uni.tuebingen.de
Beutel
Julia
J
Süsskind
Daniela
D
Hilgers
Ralf-Dieter
RD
Ziemssen
Focke
F
Lüke
Matthias
M
Röcken
Martin
M
Rohrbach
Martin
M
Fierlbeck
Gerhard
G
Bartz-Schmidt
Karl-Ulrich
KU
Grisanti
Salvatore
S
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*