MART-1 is expressed less frequently on circulating melanoma cells in patients who develop distant compared with locoregional metastases

被引:68
作者
Curry, BJ
Myers, K
Hersey, P
机构
[1] Mater Misericordiae Univ Hosp, Immunol & Oncol Unit, Newcastle, NSW 2300, Australia
[2] Sydney Melanoma Unit, Sydney, NSW, Australia
关键词
D O I
10.1200/JCO.1999.17.8.2562
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: Polymerase chain reaction (PCR) with tyrosinase and with MART-1 permits detection of small numbers of circulating melanoma cells (CMCs) in patients who have undergone surgical resection of localized disease. In a previous study, we showed that PCR with MART-1 had sensitivity and specificity similar to those of PCR with tyrosinase in terms of detection of CMCs but that PCR with MART-1 seemed to identify a different but overlapping subgroup of patients. In the current study we examined the utility and prognostic significance of PCR with tyrosinase and with MART-1. Patients and Methods: We analyzed the prognostic significance of the patterns of expression of tyrosinase and MART-1 in 186 patients followed sequentially before and after surgical removal of American Joint Committee on Cancer stage I, II, or III melanoma. Results: PCR with tyrosinase and with MART-1 in the first 3 months after surgery identified 68.5% of 73 patients who developed recurrence in the 2-year period after surgery. Approximately 35% of patients with positive tests remained disease-free at 5-year followup. We found that patients with disseminated recurrence had a significantly lower incidence of MART-1-positive CMCs (16%) than of tyrosinase-positive CMCs (63%). Patients with locoregional metastases had CMCs that expressed tyrosinase and MART-1 at similar rates. These differences in expression of the markers in patients with disseminated recurrence were also associated with a much lower disease-free survival, in those who had CMCs that were positive for tyrosinase but negative for MART-1. The reverse applied in those with locoregional disease. Conclusion: These findings suggest that PCR with MART-1 and with tyrosinase identifies subgroups of patients who develop disseminated or locally recurrent metastases. We hypothesize that immune responses against MART-I may reduce the establishment of disseminated metastases. (C) 1999 by American Society of Clinical Oncology.
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页码:2562 / 2571
页数:10
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