title: Prognostic value of antibodies to Merkel cell polyomavirus T antigens and VP1 protein in patients with Merkel cell carcinoma.
abstract: BACKGROUND
  Merkel cell polyomavirus (MCPyV) is the main aetiological agent of Merkel cell carcinoma (MCC). Serum antibodies against the major MCPyV capsid protein (VP1) are detected in the general population, whereas antibodies against MCPyV oncoproteins (T antigens) have been reported specifically in patients with MCC.
  
  
  OBJECTIVE
  The primary aim was to assess whether detection of serum antibodies against MCPyV proteins at baseline was associated with disease outcome in patients with MCC. The secondary aim was to establish whether evolution of these antibodies during follow-up was associated with the course of the disease.
  
  
  METHODS
  Serum T-antigen and VP1 antibodies were assessed by enzyme-linked immunosorbent assay using recombinant proteins in a cohort of 143 patients with MCC, including 84 patients with serum samples available at baseline.
  
  
  RESULTS
  Low titres of VP1 antibodies at baseline (< 10 000) were significantly and independently associated with increased risk of recurrence [hazard ratio (HR) 2·71, 95% confidence interval (CI) 1·13-6·53, P = 0·026] and death (HR 3·74, 95% CI 1·53-9·18, P = 0·004), whereas T-antigen antibodies were not found to be associated with outcome. VP1 antibodies did not differ between patients in remission and those with recurrence or progression during follow-up. However, T-antigen antibodies were more frequently detected in patients with recurrence or progression at 12 months (P = 0·020) and 24 months (P = 0·016) after diagnosis.
  
  
  CONCLUSIONS
  VP1 antibodies constitute a prognostic marker at baseline, whereas T-antigen antibodies constitute a marker of disease recurrence or progression if detected > 12 months after diagnosis.
authors.affiliation: Université François Rabelais, Tours, France.|INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France.|Dermatology Department, CHU Tours, Avenue de la République, 37170, Tours, France.
authors.forename: M
authors.initials: M
authors.lastname: Samimi
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27 Rue du Fbg Saint-Jacques, 75679, Paris CEDEX 14, France.|Institut Cochin, Inserm U1016, Université Paris Descartes, 22 Rue Méchain, 75014, Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Molet
authors.affiliation: Université François Rabelais, Tours, France.|INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France.|LUNAM Université, Groupe d'Etude des Interactions Hôte-Pathogéne, UPRES EA 3142, Angers, France.
authors.forename: M
authors.initials: M
authors.lastname: Fleury
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27 Rue du Fbg Saint-Jacques, 75679, Paris CEDEX 14, France.|Institut Cochin, Inserm U1016, Université Paris Descartes, 22 Rue Méchain, 75014, Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: Laude
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27 Rue du Fbg Saint-Jacques, 75679, Paris CEDEX 14, France.
authors.forename: A
authors.initials: A
authors.lastname: Carlotti
authors.affiliation: Université François Rabelais, Tours, France.|Pathology Department, CHU Tours, Avenue de la République, 37170, Tours, France.
authors.forename: C
authors.initials: C
authors.lastname: Gardair
authors.affiliation: Université François Rabelais, Tours, France.|INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France.
authors.forename: M
authors.initials: M
authors.lastname: Baudin
authors.affiliation: Université François Rabelais, Tours, France.|INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France.
authors.forename: L
authors.initials: L
authors.lastname: Gouguet
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Dermatology Department, Hôpital Bichat, 46 Rue Henri Huchard, 75877, Paris CEDEX 18, France.|Assistance Publique des Hôpitaux de Paris, Dermatology Department, Hôpital Avicenne, 125, rue de Stalingrad, 93009, Bobigny, France.
authors.forename: E
authors.initials: E
authors.lastname: Maubec
authors.affiliation: LUNAM Université, CHU Angers, Dermatology Department, 4 Rue Larrey, 49933, Angers, France.
authors.forename: M
authors.initials: M
authors.lastname: Avenel-Audran
authors.affiliation: CHR Orléans, Dermatology Department, 14 Avenue de l'Hôpital, 45067, Orléans CEDEX 2, France.
authors.forename: E
authors.initials: E
authors.lastname: Esteve
authors.affiliation: CHU Poitiers, Dermatology Department, 2 Rue de la Milétrie, 86021, Poitiers CEDEX, France.
authors.forename: E
authors.initials: E
authors.lastname: Wierzbicka-Hainaut
authors.affiliation: CHR Le Mans, Dermatology Department, 194 Avenue Rubillard, 72037, Le Mans CEDEX 09, France.
authors.forename: N
authors.initials: N
authors.lastname: Beneton
authors.affiliation: Université de Franche Comté, EA3181, SFR 4234, CHU Besançon, Dermatology Department, 2 Boulevard Fleming, 25030, Besançon, France.
authors.forename: F
authors.initials: F
authors.lastname: Aubin
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27 Rue du Fbg Saint-Jacques, 75679, Paris CEDEX 14, France.|Institut Cochin, Inserm U1016, Université Paris Descartes, 22 Rue Méchain, 75014, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Rozenberg
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27 Rue du Fbg Saint-Jacques, 75679, Paris CEDEX 14, France.|Institut Cochin, Inserm U1016, Université Paris Descartes, 22 Rue Méchain, 75014, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Dupin
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27 Rue du Fbg Saint-Jacques, 75679, Paris CEDEX 14, France.|Institut Cochin, Inserm U1016, Université Paris Descartes, 22 Rue Méchain, 75014, Paris, France.
authors.forename: M F
authors.initials: MF
authors.lastname: Avril
authors.affiliation: Université François Rabelais, Tours, France.|INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France.|Dermatology Department, CHU Tours, Avenue de la République, 37170, Tours, France.
authors.forename: G
authors.initials: G
authors.lastname: Lorette
authors.affiliation: Université François Rabelais, Tours, France.|Pathology Department, CHU Tours, Avenue de la République, 37170, Tours, France.
authors.forename: S
authors.initials: S
authors.lastname: Guyetant
authors.affiliation: Université François Rabelais, Tours, France.|INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France.
authors.forename: P
authors.initials: P
authors.lastname: Coursaget
authors.affiliation: Université François Rabelais, Tours, France.|INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France.
authors.forename: A
authors.initials: A
authors.lastname: Touzé
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000957:Antigens, Viral, Tumor / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D036022:Capsid Proteins / Q000097:blood*; D015266:Carcinoma, Merkel Cell / Q000276:immunology* / Q000401:mortality; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D059965:Merkel cell polyomavirus / Q000276:immunology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000276:immunology / Q000401:mortality; D027601:Polyomavirus Infections / Q000276:immunology / Q000401:mortality; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D012878:Skin Neoplasms / Q000276:immunology* / Q000401:mortality; D014412:Tumor Virus Infections / Q000276:immunology
chemical_list: D000957:Antigens, Viral, Tumor; D014408:Biomarkers, Tumor; D036022:Capsid Proteins; C062481:VP1 protein, polyomavirus