Quantitative detection of melanoma-associated antigens by multimarker real-time RT-PCR for molecular staging: results of a 5 years study.
BACKGROUND
Monitoring of circulating melanoma cells in the peripheral blood is a promising method for identifying a subgroup of patients with minimal residual disease.


OBJECTIVE
To evaluate the prognostic impact of melanoma-associated antigens by multimarker real-time RT-PCR for disease-specific survival time.


METHODS
Five melanoma markers: Melan-A, gp 100, MAGE-3, MIA and tyrosinase were detected by a quantitative multimarker real-time reverse transcription-PCR (RT-PCR). We included 65 patients with resected melanoma in stage II-III. Peripheral blood samples were examined every 3 months for 2 years. The expression of melanoma markers in 2925 RT-PCR assays was correlated with clinical staging results in total of 5 years.


RESULTS
Twenty-seven patients relapsed during the study period and 26 of them revealed positive markers. MAGE-3 was the most sensitive progression marker in single occurrence or in combination with MIA and gp 100. The time distribution of metastases during the screened period was as follows: progression in the first year was observed in 40.7% patients, second year in 25.9%, third year in 18.6%, fourth and fifth year in 7.4% equally.


CONCLUSIONS
Statistically significant tumor marker elevation during the first 2 years after the surgical treatment correlates with a worse prognosis of patients. In contrast, the group showing negative real-time RT-PCR results in 24 months serial blood testing was associated with prolonged 5-year disease-specific survival. Therefore, quantitative detection of melanoma-specific molecular markers in the presented setting represents a useful tool for selecting patients in a higher risk of disease recurrence.
Gkalpakiotis
Spyridon
S
Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic. spyros@centrum.cz
Arenberger
Petr
P
Kremen
Jaromir
J
Arenbergerova
Monika
M
D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000235:genetics; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000235:genetics; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D015870:Gene Expression / Q000235:genetics; D006801:Humans; D007962:Leukocytes / Q000737:chemistry; D058965:MART-1 Antigen / Q000235:genetics; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D058950:Melanoma-Specific Antigens / Q000235:genetics*; D008875:Middle Aged; D014442:Monophenol Monooxygenase / Q000235:genetics; D009363:Neoplasm Proteins / Q000235:genetics; D009367:Neoplasm Staging; D011379:Prognosis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055815:Young Adult; D058951:gp100 Melanoma Antigen / Q000235:genetics
D000951:Antigens, Neoplasm; D015295:Antigens, Tumor-Associated, Carbohydrate; C072013:MAGEA3 protein, human; D058965:MART-1 Antigen; C074879:MIA antigen, human; C548667:MLANA protein, human; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins; D058951:gp100 Melanoma Antigen; D014442:Monophenol Monooxygenase