Lack of Prognostic Importance of Reverse-Transcriptase Polymerase Chain Reaction Detection of Circulating Messenger RNA in Patients with Melanoma

Abstract

The use of polymerase chain reaction to detect circulating tyrosinase mRNA in peripheral blood does not correlate with traditional prognostic indicators in patients with cutaneous melanoma and does not appear to be an effective prognostic tool.

Tumor cell and circulating markers in melanoma: Diagnosis, prognosis, and management

“…The tyrosinase-related proteins 1 and 2 (TRP-1, TRP-2) were thought to be more sensitive markers for the detection of melanoma than tyrosinase but have not shown sufficient sensitivity and specificity in most studies to supplant tyrosinase [11,13,19]. The problem seems not to be the ability to detect circulating melanoma cells but that the presence of circulating melanoma cells does not necessarily correlate with prognosis [15,17,18]. Nonspecific tumor markers, such as the cancer-testis antigen MAGE-3 and the tumor marker gp100, have also been studied but were found no more useful than tyrosinase and MART-1 in following patients with local/regional spread of melanoma [25].…”

“…Interestingly, this serum factor is among the most predictive independent factors of diminished survival in patients with advanced [18] 2005…”

Prognostic value of microphthalmia-associated transcription factor and tyrosinase as markers for circulating tumor cells detection in patients with melanoma

“…An association between the distribution of tyrosinase value and stage of the disease has been studied elsewhere and the majority of these studies have confirmed a statistically significant increase in the proportion of tyrosinase positive patients with the increasing stage of the disease [7,16,17,20,22,25,26,29,30]. Still, some other studies have shown no statistically significant association between the distribution of the tyrosinase value and the stage of the disease [12,13,24,34]. Because the stage of the disease correlates strongly with patients' survival, an association with the stage of the disease was studied as a surrogate indicator of the prognostic value of markers for the detection of circulating melanoma cells [3].…”

“…Several studies have shown that the presence of circulating melanoma cells detected by RT-PCR is associated with shorter overall and progression-free survival [9][10][11][12][13][14][15][16][17][18][19][20][21][28][29][30][31][32]. But other studies did not confirm the prognostic value of RT-PCR detection of circulating melanoma cells [22,23,[33][34][35][36]. metastases and negative values of investigated markers.…”

Clinical significance of the RT‐PCR positive sentinel node in melanoma

“…In the analysis of peripheral blood for tyrosinase mRNA, several groups have shown a correlation of RT-PCR positivity with stage and progression of disease [22][23][24][25][26]51], and responsiveness of RT-PCR to decreasing tumor load with regression after immunotherapy [27]. These findings have been refuted by others [28] as not adding prognostic information beyond what is provided by tumor thickness [29]. Schmidt [30] found that although mRNA for tyrosinase in peripheral blood following interleukin-2 immunotherapy for metastatic melanoma is related to poor survival, circulating mRNA for tyrosinase and MART-1 did not predict relapse or survival in patients with Stage I and II melanoma [29].…”