Impact of Molecular Staging Methods in Primary Melanoma: Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR) of Ultrasound-Guided Aspirate of the Sentinel Node Does Not Improve Diagnostic Accuracy, But RT-PCR of Peripheral Blood Does Predict Survival
| Autor: | Joachim Röwert-Huber, Markus Schwürzer-Voit, Gregor Schäfer-Hesterberg, Martina Kron, Ansgar Lukowsky, Alexander M.M. Eggermont, Juergen Rademaker, A. Schoengen, Markus Krause, Wolfram Sterry, Alexander C.J. van Akkooi, Christiane Voit |
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| Přispěvatelé: | Surgery, Pharmacy |
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Pathology Biopsy Fine-Needle Sentinel lymph node Sensitivity and Specificity Disease-Free Survival Gene Expression Regulation Enzymologic Young Adult Predictive Value of Tests Cytology Biopsy Biomarkers Tumor Humans Medicine Prospective Studies Melanoma Ultrasonography Interventional Aged Neoplasm Staging Aged 80 and over medicine.diagnostic_test Monophenol Monooxygenase Reverse Transcriptase Polymerase Chain Reaction Sentinel Lymph Node Biopsy business.industry Reproducibility of Results Middle Aged Sentinel node medicine.disease Survival Analysis Gene Expression Regulation Neoplastic Reverse transcription polymerase chain reaction Treatment Outcome Real-time polymerase chain reaction Oncology Lymphatic Metastasis Predictive value of tests Female Lymph Nodes Radiology business |
| Zdroj: | Journal of Clinical Oncology, 26(35), 5742-5747. American Society of Clinical Oncology |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2007.13.7653 |
| Popis: | Purpose This study analyzes (1) the value of tyrosinase reverse-transcriptase polymerase chain reaction (RT-PCR) of aspirates obtained by ultrasound-guided fine-needle aspiration cytology (US-FNAC) of sentinel nodes (SNs) in patients with melanoma before sentinel lymph node biopsy (SLNB) and (2) the value of RT-PCR of blood samples of all SLNB patients. Patients and Methods Between 2001 and 2003, 127 patients with melanoma (median Breslow depth, 2.1 mm) underwent SLNB. FNAC was performed in all SNs of all patients pre- and post-SLNB. The aspirates were partly shock-frozen for RT-PCR and were partly used for standard cytology. Peripheral blood was collected at the time of SLNB and at every outpatient visit thereafter. Results Thirty-four (23%) of 120 SNs were positive for melanoma. SN involvement was predicted by US-FNAC with a sensitivity of 82% and a specificity of 72%. Additional tyrosinase RT-PCR revealed the same sensitivity of 82% and a specificity of 72%. At a median follow-up time of 40 months from first blood sample, peripheral-blood RT-PCR was a significant independent predictor of disease-free survival (DFS) and overall survival (OS; P < .001). Conclusion US-FNAC is highly accurate and eliminates the need for SLNB in 16% of all SLNB patients. RT-PCR of the aspirate or excised SN does not improve sensitivity or specificity. RT-PCR of blood samples predicts DFS and OS. |
| Databáze: | OpenAIRE |
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