Biological value of melanoma inhibitory activity serum concentration in patients with primary skin melanoma

Abstract

Melanoma inhibitory activity (MIA) protein was identified in significant quantities in primary and metastatic malignant melanomas, where it has an important role in promoting tumor development and progression. Our hypothesis was that MIA serum level will be elevated in patients with metastases or local spreading of the disease before any symptom of such progression is clinically apparent. We compared MIA serum levels in two groups of patients with primary melanoma; those with positive as opposed to those with negative sentinel lymph nodes. In addition, MIA serum levels were studied in two control groups; patients with dysplastic nevi and patients with basal cell carcinoma. A blood sample was obtained from each patient included in the study and MIA levels were assessed using standard enzyme-linked immunosorbent assay method. Patients with histologically positive sentinel lymph nodes, meaning that tumor cells were found in the lymph nodes, had much higher mean MIA values than any other patient group considered in this study. With mean value of 14.53 ng/ml, it was almost twice as high as mean MIA value in patients with histologically negative sentinel lymph nodes (7.32 ng/ml) and more than twice as high than any of the two control groups (P<0.001). However, neither the classification by Clarke nor the classification by Breslow could be used to distinguish patients with positive sentinel lymph nodes from those with negative sentinel lymph nodes. In our opinion, MIA serum level is the ideal test for screening the tumor spread to sentinel lymph nodes.

Impact of lymph node metastases on serum level of melanoma inhibitory activity in stage III melanoma patients

“…In a recent study, it was suggested that the MIA serum marker was the best predictive test for identifying positive SLN 13 . In this study, the number of involved nodes was not analyzed.…”

“…In a recent study, it was suggested that the MIA serum marker was the best predictive test for identifying positive SLN. 13 In this study, the number of involved nodes was not analyzed. In our study, we found a correlation between MIA values and the number of affected nodes in the first draining lymph node basin.…”

“…In disease‐free stage III melanoma patients, the sensitivity of MIA has been reported in the range of 22–80% 7,11,12 . Recently, patients with primary cutaneous melanoma were reported to show an elevated MIA (14.53 ng/mL) in case of positivity of the SLN as compared to patients with negative SLN (7.32 ng/mL) 13 . In a prior study with stage I and II melanoma patients, we defined the optimal cut‐off of 12.0 ng/mL, when compared to 8.8 and 15.0 ng/mL 14 …”

“…7,11,12 Recently, patients with primary cutaneous melanoma were reported to show an elevated MIA (14.53 ng ⁄ mL) in case of positivity of the SLN as compared to patients with negative SLN (7.32 ng ⁄ mL). 13 In a prior study with stage I and II melanoma patients, we defined the optimal cut-off of 12.0 ng ⁄ mL, when compared to 8.8 and 15.0 ng ⁄ mL. 14 The aim of this study was to investigate the clinical impact of serum MIA values in consecutive mela-noma patients in stage III during primary diagnosis and in the routine follow up.…”

MIA is a potential biomarker for tumour load in neurofibromatosis type 1

“…The last, MIA , is also known as cartilage-derived retinoic acid sensitive protein ( cd-rap ) and was originally isolated as a secretory factor from supernatants of melanoma cell cultures [12]. MIA serum level was found to correlate with melanoma spreading [13] and was proposed as a biomarker for monitoring the course of disease and the efficacy of therapies [14]. Various other tumours, predominantly those of neuroectodermal, glial origin, also express MIA [15].…”