摘要
The detection of melanoma cells in peripheral blood has been proposed to select patients with a high risk of relapse. In this study, tyrosinase and melanoma antigen recognized by T cells 1 (MART-1) mRNA expression was evaluated in serial samples obtained before definitive surgery and during follow-up in patients with American Joint Committee on Cancer stage I-II melanoma. Serial samples (n = 2,262) were collected from 236 patients from 1997 to 2002. Analyses of the RNA samples were performed with a calibrated reverse transcriptase-PCR assay. Gender, age, primary tumor site, ulceration, thickness, Clark level, and histological subtype were analyzed together with tyrosinase and MART-1 mRNA treated as updated covariates in a Cox proportional-hazard model. After a median follow-up time of 66 months, 42 out of 236 patients (18%) had relapsed. The following variables were significantly associated with relapse free survival in the univariate analyses: tyrosinase, MART-1, gender, ulceration, thickness, Clark level, and histological subtype. Entering these covariates into a multivariate Cox analysis resulted in thickness as the single independent prognostic factor (P < 0.0001), whereas MART-1 (P = 0.07) approached significance at the 5%significance level. The serial measurements of tyrosinase and MART-1 mRNA in peripheral blood of stage I-II melanoma patients cannot be demonstrated to have independent prognostic impact on relapse free survival.
The detection of melanoma cells in peripheral blood has been proposed to select patients with a high risk of relapse. In this study, tyrosinase and melanoma antigen recognized by T cells 1 （MART-1） mRNA expression was evaluated in serial samples obtained before definitive surgery and during follow-up in patients with American Joint Committee on Cancer stage Ⅰ- Ⅱ melanoma. Serial samples （n = 2, 262） were collected from 236 patients from 1997 to 2002. Analyses of the RNA samples were performed with a calibrated reverse transcriptase-PCR assay. Gender, age, primary tumor site, ulceration, thickness, Clark level, and histological subtype were analyzed together with tyrosinase and MART-1 mRNA treated as updated covariates in a Cox proportional-hazard model. After a median follow-up time of 66 months, 42 out of 236 patients （ 18% ） had relapsed.The following variables were significantly associated with relapse free survival in the univariate analyses： tyrosinase, MART-1, gender, ulceration, thickness, Clark level, and histological subtype. Entering these covariates into a multivariate Cox analysis resulted in thickness as the single independent prognostic factor MART-1 （P = 0. 07） approach （P〈 0.0001）, whereas ed significance at the 5% significance level. The serial measurements of tyrosinase and MART-1 mRNA in peripheral blood of stage Ⅰ- Ⅱ melanoma patients cannot be demonstrated to have independent prognostic impact on relapse free survival.
