title: Serum amyloid A as a prognostic marker in melanoma identified by proteomic profiling.
abstract: OBJECTIVE
  Currently known prognostic serum biomarkers of melanoma are powerful in metastatic disease, but weak in early-stage patients. This study was aimed to identify new prognostic biomarkers of melanoma by serum mass spectrometry (MS) proteomic profiling, and to validate candidates compared with established markers.
  
  
  METHODS
  Two independent sets of serum samples from 596 melanoma patients were investigated. The first set (stage I = 102; stage IV = 95) was analyzed by matrix assisted laser desorption and ionization time of flight (MALDI TOF) MS for biomarkers differentiating between stage I and IV. In the second set (stage I = 98; stage II = 91; stage III = 87; stage IV = 103), the serum concentrations of the candidate marker serum amyloid A (SAA) and the known biomarkers S100B, lactate dehydrogenase, and C reactive protein (CRP) were measured using immunoassays.
  
  
  RESULTS
  MALDI TOF MS revealed a peak at m/z 11.680 differentiating between stage I and IV, which could be identified as SAA. High peak intensities at m/z 11.680 correlated with poor survival. In univariate analysis, SAA was a strong prognostic marker in stage I to III (P = .043) and stage IV (P = .000083) patients. Combination of SAA and CRP increased the prognostic impact to P = .011 in early-stage (I to III) patients. Multivariate analysis revealed sex, stage, tumor load, S100B, SAA, and CRP as independent prognostic factors, with an interaction between SAA and CRP. In stage I to III patients, SAA combined with CRP was superior to S100B in predicting patients' progression-free and overall survival.
  
  
  CONCLUSIONS
  SAA combined with CRP might be used as prognostic serological biomarkers in early-stage melanoma patients, helping to discriminate low-risk patients from high-risk patients needing adjuvant treatment.
authors.affiliation: Institute for Clinical Chemistry, Medical Faculty Mannheim of University of Heidelberg, Heidelberg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Findeisen
authors.forename: Marc
authors.initials: M
authors.lastname: Zapatka
authors.forename: Teresa
authors.initials: T
authors.lastname: Peccerella
authors.forename: Heike
authors.initials: H
authors.lastname: Matzk
authors.forename: Michael
authors.initials: M
authors.lastname: Neumaier
authors.forename: Dirk
authors.initials: D
authors.lastname: Schadendorf
authors.forename: Selma
authors.initials: S
authors.lastname: Ugurel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008545:Melanoma / Q000097:blood* / Q000401:mortality; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000097:blood; D011379:Prognosis; D040901:Proteomics; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood; D000685:Serum Amyloid A Protein / Q000032:analysis*; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
chemical_list: D014408:Biomarkers, Tumor; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase