title: Biomarker value and pitfalls of serum S100B in the follow-up of high-risk melanoma patients.
abstract: OBJECTIVE
  Serum levels of S100B are standard in monitoring advanced malignant melanoma patients in order to discriminate progressive from non-progressive disease. False-positive results lead to distress among patients and increase the amount of cost-intensive diagnostics. We therefore analyzed reported comorbid diseases as putative sources of excessive S100B release.
  
  
  METHODS
  Here, we report a single-center experience on serum S100B levels in 2,664 blood samples from 1,113 stage IB to IV melanoma patients (AJCC) who presented for follow-up examinations over a period of 24 months.
  
  
  RESULTS
  Overall, 295 (11%) of patients developed disease progression. In patients with a high tumor load, the rate of false-negative results was 30/185 (16%). The rate of false-positive results was 247/2369 (12%). One hundred and six false-positive results (69%) compared to 46 true-positive results (31%) were found in patients with cardiovascular diseases such as arrhythmia (50/32) or previous myocardial infarction (22/14). Moreover, obesity (85/14), liver cirrhosis (31/10), migraine (18/2), chronic kidney disease (13/2), and previous stroke (11/1) were found to be associated with false-positive S100B levels.
  
  
  CONCLUSIONS
  Serum S100B is a useful quantitative biomarker in routine follow-up of high-risk melanoma patients. While false-negative results are frequent in patients with low tumor load, false-positive results are associated with several comorbid diseases and warrant careful reevaluation.
authors.affiliation: German Cancer Research Center (DKFZ), Skin Cancer Unit, Heidelberg and University Medical Center Mannheim, Department of Dermatology, Venereology and Allergology, Ruprecht-Karl University of Heidelberg, Mannheim, Germany.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Gebhardt
authors.affiliation: German Cancer Research Center (DKFZ), Skin Cancer Unit, Heidelberg and University Medical Center Mannheim, Department of Dermatology, Venereology and Allergology, Ruprecht-Karl University of Heidelberg, Mannheim, Germany.
authors.forename: Ramtin
authors.initials: R
authors.lastname: Lichtenberger
authors.affiliation: German Cancer Research Center (DKFZ), Skin Cancer Unit, Heidelberg and University Medical Center Mannheim, Department of Dermatology, Venereology and Allergology, Ruprecht-Karl University of Heidelberg, Mannheim, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Utikal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008545:Melanoma / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood*; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human