title: Melanoma MicroRNA signature predicts post-recurrence survival.
abstract: OBJECTIVE
  To identify a melanoma microRNA (miRNA) expression signature that is predictive of outcome and then evaluate its potential to improve risk stratification when added to the standard-of-care staging criteria.
  
  
  METHODS
  Total RNA was extracted from 59 formalin-fixed paraffin-embedded melanoma metastases and hybridized to miRNA arrays containing 911 probes. We then correlated miRNA expression with post-recurrence survival and other clinicopathologic criteria.
  
  
  RESULTS
  We identified a signature of 18 miRNAs whose overexpression was significantly correlated with longer survival, defined as more than 18 months post-recurrence survival. Subsequent cross-validation showed that a small subset of these miRNAs can predict post-recurrence survival in metastatic melanoma with an estimated accuracy of 80.2% (95% confidence interval, 79.8-80.6%). In contrast to standard-of-care staging criteria, a six-miRNA signature significantly stratified stage III patients into "better" and "worse" prognostic categories, and a multivariate Cox regression analysis revealed the signature to be an independent predictor of survival. Furthermore, we showed that most miRNAs from the signature also showed differential expression between patients with better and worse prognoses in the corresponding paired primary melanoma.
  
  
  CONCLUSIONS
  MiRNA signatures have potential as clinically relevant biomarkers of prognosis in metastatic melanoma. Our data suggest that molecularly based models of risk assessment can improve the standard staging criteria and support the incorporation of miRNAs into such models.
authors.affiliation: Department of Pathology, New York University School of Medicine, New York, New York, USA.
authors.forename: Miguel F
authors.initials: MF
authors.lastname: Segura
authors.forename: Ilana
authors.initials: I
authors.lastname: Belitskaya-Lévy
authors.forename: Amy E
authors.initials: AE
authors.lastname: Rose
authors.forename: Jan
authors.initials: J
authors.lastname: Zakrzewski
authors.forename: Avital
authors.initials: A
authors.lastname: Gaziel
authors.forename: Douglas
authors.initials: D
authors.lastname: Hanniford
authors.forename: Farbod
authors.initials: F
authors.lastname: Darvishian
authors.forename: Russell S
authors.initials: RS
authors.lastname: Berman
authors.forename: Richard L
authors.initials: RL
authors.lastname: Shapiro
authors.forename: Anna C
authors.initials: AC
authors.lastname: Pavlick
authors.forename: Iman
authors.initials: I
authors.lastname: Osman
authors.forename: Eva
authors.initials: E
authors.lastname: Hernando
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D035683:MicroRNAs / Q000032:analysis* / Q000235:genetics; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000235:genetics* / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D020411:Oligonucleotide Array Sequence Analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012878:Skin Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D035683:MicroRNAs