Unique Genes in Tumor-Positive Sentinel Lymph Nodes Associated with Nonsentinel Lymph Node Metastases in Melanoma.
Autor: | Egger ME; Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, Louisville, KY, USA., Xiao D; Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, Louisville, KY, USA., Hao H; Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, Louisville, KY, USA., Kimbrough CW; Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, Louisville, KY, USA., Pan J; Biostatistics Shared Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA., Rai SN; Biostatistics Shared Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.; Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA., Cambon AC; Biostatistics Shared Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA., Waigel SJ; University of Louisville Genomics Facility, Louisville, KY, USA., Zacharias W; University of Louisville Genomics Facility, Louisville, KY, USA.; Departments of Medicine and Pharmacology and Toxicology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA., McMasters KM; Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, Louisville, KY, USA. mcmasters@louisville.edu. |
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Jazyk: | angličtina |
Zdroj: | Annals of surgical oncology [Ann Surg Oncol] 2018 May; Vol. 25 (5), pp. 1296-1303. Date of Electronic Publication: 2018 Mar 01. |
DOI: | 10.1245/s10434-018-6377-x |
Abstrakt: | Background: Current risk assessment tools to estimate the risk of nonsentinel lymph node metastases after completion lymphadenectomy for a positive sentinel lymph node (SLN) biopsy in cutaneous melanoma are based on clinical and pathologic factors. We identified a novel genetic signature that can predict non-SLN metastases in patients with cutaneous melanoma staged with a SLN biopsy. Methods: RNA was collected for tumor-positive SLNs in patients staged by SLN biopsy for cutaneous melanoma. All patients with a tumor-positive SLN biopsy underwent completion lymphadenectomy. A 1:10 case:control series of positive and negative non-SLN patients was analyzed by microarray and quantitative RT-PCR. Candidate differentially expressed genes were validated in a 1:3 case:control separate cohort of positive and negative non-SLN patients. Results: The 1:10 case:control discovery set consisted of 7 positive non-SLN cases matched to 70 negative non-SLN controls. The cases and controls were similar with regards to important clinicopathologic factors, such as gender, primary tumor site, age, ulceration, and thickness. Microarray and RT-PCR identified six potential differentially expressed genes for validation. In the 40-patient separate validation set, 10 positive non-SLN patients were matched to 30 negative non-SLN controls based on gender, ulceration, age, and thickness. Five of the six genes were differentially expressed. The five gene panel identified patients at low (7.1%) and high risk (66.7%) for non-SLN metastases. Conclusions: A novel, non-SLN gene score based on differential expressed genes in a tumor-positive SLN can identify patients at high and low risk for non-SLN metastases. |
Databáze: | MEDLINE |
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