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Molecular Staging of Pathologically Negative Sentinel Lymph Nodes from Melanoma Patients Using Multimarker, Quantitative Real-Time RT-PCR

  • Melanomas
  • Published:
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Abstract

The aim of this study was to evaluate the prognostic potential of quantitative reverse-transcription, polymerase chain reaction (qRT-PCR) in melanoma patients with pathologically negative sentinel lymph nodes (SLN). Our study included 195 node-negative melanoma patients with a Breslow thickness greater than 0.76 mm (n = 158), or less than 0.76 mm but who had Clark level IV–V, microscopic ulceration, or pathological signs of regression (n = 32), and five patients with melanoma of unknown thickness. SLNs were examined by serial-section histopathology. A portion of each SLN was frozen for qRT-PCR analysis using markers Tyrosinase, MART1, SSX2, MAGEA3, PAX3, and GalNAc-T. In addition, two other markers (PLAB and L1CAM) were evaluated for melanoma specificity but not for SLN analysis. Median follow-up was 64 months, during which time there were 15 (7.7%) recurrences. A total of 370 lymph nodes were analyzed by qRT-PCR. No association was found between quantitative expression level of any marker and disease recurrence. Previously published primer designs were tested for PAX3 and GalNAc-T and revealed that alternative PAX3 transcripts are differentially expressed in melanoma and benign lymph nodes. No associations with recurrence were found regardless of the transcripts amplified by different primer sets. PLAB and L1CAM did not appear to differentiate between malignant melanoma and benign melanocytes or lymph nodes in our analysis. We conclude that, in this large cohort of patients, multimarker qRT-PCR analysis of SLNs did not correlate with disease recurrence. Our data support specific PAX3 splice variants but not GalNAc-T, PLAB or L1CAM as possible markers for melanoma metastasis to SLNs.

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Acknowledgements

This work was supported by a grant from Fondo de Investigaciones Sanitarias (02/933) and this work was awarded with the Premio a la investigación biomedica “Rafael Hervada” prize 2006–2007). We thank Marc Isamat for careful review of the manuscript.

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Authors and Affiliations

  1. Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Badalona, Universidad Autónoma de Barcelona, Barcelona, Spain

    Josep M. Hilari, Cristina Mangas, Cristina Paradelo & Carlos Ferrándiz

  2. Department of Pathology, Mount Sinai School of Medicine, New York, NY, USA

    Liqiang Xi, Cindy Yueh, Ivy Altomare & Tony E. Godfrey

  3. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Steven J. Hughes

  4. Biostatistics Facility, Cancer Institute, University of Pittsburgh, Pittsburgh, PA, USA

    William E. Gooding

  5. Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue Rochester, New york, NY, 14642, USA

    Tony E. Godfrey

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  1. Josep M. Hilari
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  2. Cristina Mangas
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  3. Liqiang Xi
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Correspondence to Tony E. Godfrey.

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Josep M. Hilari and Cristina Mangas contributed equally to this work.

Electronic Supplementary Material

10434_2008_183_MOESM1_ESM.pdf

MOESM1 [Evaluation of Potential Markers for Detection of Lymph Node Metastasis inMelanoma Using Quantitative RT-PCR] (PDF 241 kb)

Supplemental Figure 2

MOESM1 [Exon structure of PAX3 alternative transcriptsindicating the location of the two PCR primer designs used in this study.Our primer design amplifies all 7 known transcripts whereas the design ofTakeuchi et al. only amplifies 3 transcripts.] (PDF 18 kb)

Supplemental Table 1

MOESM1 [Oligonucleotide primer and probe sequences used] (PDF 63 kb)

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Hilari, J.M., Mangas, C., Xi, L. et al. Molecular Staging of Pathologically Negative Sentinel Lymph Nodes from Melanoma Patients Using Multimarker, Quantitative Real-Time RT-PCR. Ann Surg Oncol 16, 177–185 (2009). https://doi.org/10.1245/s10434-008-0183-9

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