title: Increased shedding of HU177 correlates with worse prognosis in primary melanoma.
abstract: BACKGROUND
  Increased levels of cryptic collagen epitope HU177 in the sera of melanoma patients have been shown to be associated with thicker primary melanomas and with the nodular histologic subtype. In this study, we investigate the association between HU177 shedding in the sera and clinical outcome in terms of disease-free survival (DFS) and overall survival (OS).
  
  
  METHODS
  Serum samples from 209 patients with primary melanoma prospectively enrolled in the Interdisciplinary Melanoma Cooperative Group at the New York University Langone Medical Center (mean age = 58, mean thickness = 2.09 mm, stage I = 136, stage II = 41, stage III = 32, median follow-up = 54.9 months) were analyzed for HU177 concentration using a validated ELISA assay. HU177 serum levels at the time of diagnosis were used to divide the study cohort into two groups: low and high HU177. DFS and OS were estimated by Kaplan-Meier survival analysis, and the log-rank test was used to compare DFS and OS between the two HU177 groups. Multivariate Cox proportional hazards regression models were employed to examine the independent effect of HU177 category on DFS and OS.
  
  
  RESULTS
  HU177 sera concentrations ranged from 0-139.8 ng/ml (mean and median of 6.2 ng/ml and 3.7 ng/ml, respectively). Thirty-eight of the 209 (18%) patients developed recurrences, and 34 of the 209 (16%) patients died during follow-up. Higher HU177 serum level was associated with an increased rate of melanoma recurrence (p = 0.04) and with increasing mortality (p = 0.01). The association with overall survival remained statistically significant after controlling for thickness and histologic subtype in a multivariate model (p = 0.035).
  
  
  CONCLUSIONS
  Increased shedding of HU177 in the serum of primary melanoma patients is associated with poor prognosis. Further studies are warranted to determine the clinical utility of HU177 in risk stratification compared to the current standard of care.
authors.affiliation: Department of Dermatology, New York University School of Medicine, New York, NY, USA.
authors.forename: Heather K
authors.initials: HK
authors.lastname: Hamilton
authors.forename: Amy E
authors.initials: AE
authors.lastname: Rose
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Christos
authors.forename: Richard L
authors.initials: RL
authors.lastname: Shapiro
authors.forename: Russell S
authors.initials: RS
authors.lastname: Berman
authors.forename: Madhu
authors.initials: M
authors.lastname: Mazumdar
authors.forename: Michelle W
authors.initials: MW
authors.lastname: Ma
authors.forename: Daniel
authors.initials: D
authors.lastname: Krich
authors.forename: Leonard
authors.initials: L
authors.lastname: Liebes
authors.forename: Peter C
authors.initials: PC
authors.lastname: Brooks
authors.forename: Iman
authors.initials: I
authors.lastname: Osman
mesh_terms: D000328:Adult; D000368:Aged; D003094:Collagen / Q000097:blood / Q000276:immunology; D018572:Disease-Free Survival; D000939:Epitopes / Q000097:blood / Q000276:immunology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D016019:Survival Analysis
chemical_list: D000939:Epitopes; D003094:Collagen