Detection of Submicroscopic Lymph Node Metastases with Polymerase Chain Reaction in Patients with Malignant Melanoma

Wang, X; Heller, Richard; VanVoorhis, N; Cruse, C. Wayne; Glass, Frank; Fenske, N; Berman, C; Leo-Messina, J; Rappaport, David P.; Wells, Karen

doi:10.1097/00000658-199412000-00010

Cited by 258 publications

(94 citation statements)

References 20 publications

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“…PCR is a laboratory process in which a particular DNA segment is rapidly replicated in order to produce a larger quantity of DNA for chemical analysis. Initially, melanoma cells were detected using RT-PCR for evaluation of the tyrosinase enzyme, which has a specific marker for metastatic melanoma cells [14].…”

Section: Introductionmentioning

confidence: 99%

Current Status of Sentinel Lymph Node Mapping and Biopsy: Facts and Controversies

2003

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Lymphatic mapping and sentinel lymph node biopsy were first reported in 1977 by Cabanas for penile cancer. Since that time, the technique has become rapidly assimilated into clinical practice. Morton first described the application of lymphatic mapping for melanoma only a decade ago, and this technique is now accepted as the standard of care. The application for lymphatic mapping and sentinel lymph node biopsy in breast cancer remains approximately 5 years behind its utilization in melanoma.This technique has the potential to be utilized in all solid tumors. The rapid assent of this technique in clinical practice is the result of multiple factors, including accuracy, decreased morbidity, and supplying the pathologist with only a few nodes to allow a more focused and sensitive pathologic evaluation. Despite the success and acceptance of lymphatic mapping, many controversies remain. We have attempted to clearly highlight these controversies in this review.

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Section: Introductionmentioning

confidence: 99%

Current Status of Sentinel Lymph Node Mapping and Biopsy: Facts and Controversies

2003

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“…Detection of tyrosinase-RNA, a tissue-specific enzyme regulating melanin biosynthesis (Kwon et al, 1987;Ponnazhagen et al, 1994), by use of reverse transcription (RT) and polymerase chain reaction (PCR) was originally described for melanoma cells circulating in peripheral blood (Smith et al, 1991). The use of the tyrosinase-RT-PCR method was later transferred to detect occult melanoma micrometastases in lymph nodes (Wang et al, 1994;Schwürzer-Voit et al, 1996;van-der-Verde et al, 1996) and also in the s.c. fat tissue adjacent to primary melanomas .…”

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confidence: 99%

Detection of regional melanoma metastases by ultrasound B-scan, cytology or tyrosinase RT-PCR of fine-needle aspirates

et al. 1999

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Summary Physical examination and ultrasound B-scan screening are important follow-up procedures in melanoma patients with regional disease. However, they do not allow definite diagnosis of suspicious lesions. Fine-needle aspiration cytology (FNAC) enhances the diagnostic accuracy in such patients but, unfortunately, reaches its technical limits, particularly when very small or necrotic lesions are examined. We therefore tested whether tyrosinase reverse transcription polymerase chain reaction (RT-PCR) of fine-needle aspirates (FNA-PCR) could help to increase diagnostic sensitivity. With clinical follow-up in 69 melanoma patients 81 regional lymph nodes were detected by ultrasound Bscan examination, nine of whom appeared to be palpable. Technically, FNAC was successful in all 81 lymph nodes, while FNA-PCR failed to obtain RNA at detectable levels in two lymph nodes of two patients. Of 79 lesions which have been completely evaluated by B-scan, FNAC and FNA-PCR, 44 proved to be melanoma metastases by histopathology, while the remaining 35 lesions were finally classified as non-specific lymph nodes. Of the 44 melanoma metastases 80% (n = 35) have been detected by B-scan, 90% (n = 39) by FNAC and 100% (n = 44) by FNA-PCR (P < 0.05 vs FNAC, P < 0.005 vs B-scan). In the subclass of lesions with diameters below 10 mm the sensitivities were 72% (n = 13), 78% (n = 14) and 100% (n = 18) respectively. In 35 regional lymph nodes classified as benign lesions, FNAC was always negative while FNA-PCR produced one positive result. Neither of these methods did produce false positive results in 15 control lymph nodes of non-melanoma patients. We conclude, that FNA-PCR might have superior sensitivity as compared to FNAC or ultrasound B-scan, particularly in melanoma lesions with diameters below 10 mm.Keywords: melanoma; ultrasound guided fine needle aspiration cytology (FNAC); tyrosinase reverse transcription polymerase chain reaction (RT-PCR); RT/PCR of fine needle aspiration material (FNA-PCR)

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“…Secondly, studies of lymph nodes of patients with stage I or II malignant melanoma (AJCC classification), thus with clinically negative nodes, showed results that do not seem to correspond with the clinical outcome. For instance Wang et al (1994) found in 66% of 29 regional lymph node samples tyrosinase positivity by RT-PCR, in melanoma patients with a stage I or II melanoma. Therefore, the specificity of the tyrosinase mRNA as a tumour marker in lymph nodes should be further evaluated.…”

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confidence: 99%

“…Although clinical parameters such as lymph node involvement and thickness of the tumour are helpful, other diagnostic tools are urgently needed to allow for optimal prediction of the clinical course and choice of treatment. For this purpose efforts have been made to detect micrometastases in blood (Brossart et al, 1995;Foss et al, 1995;Hoon et al, 1995;Buzaid and Balch 1996;Mellado et al, 1996;Gläser et al, 1997;Jung et al, 1997;Reinhold et al, 1997;Farthmann et al, 1998;Ghossein et al, 1998;Curry et al, 1998;De Vries et al, 1999;Palmieri et al, 1999) and in the regional lymph nodes by immunohistochemistry or reverse transcriptase polymerase chain reaction (RT-PCR) (Battyani et al, 1993;Wang et al, 1994;Rankin, 1996;Van der Velde-Zimmermann et al, 1996;Blaheta et al, 1998;Goydos et al, 1998;Hatta et al, 1998;Bieligk et al, 1999).…”

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confidence: 99%

Limitations of the nested reverse transcriptase polymerase chain reaction on tyrosinase for the detection of malignant melanoma micrometastases in lymph nodes

Calogero

Timmer‐Bosscha

Koops³

et al. 2000

Br J Cancer

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SummaryThe specificity and sensitivity of the nested reverse transcriptase polymerase chain reaction (RT-PCR) on tyrosinase was studied, for the detection of micrometastases of malignant melanoma. The specificity was assessed in the blood of six healthy donors, four patients with non-melanoma cancers of which one patient was treated with granulocyte-colony stimulating factor. Lymph nodes of nine patients without malignant melanoma were tested and four cell lines of various other tumours. Six of the nine non-melanoma lymph nodes were positive in this assay. The sensitivity was tested in a spike experiment in vitro, using a melanoma cell line. The detection limit was ten melanoma cells per 10 7 peripheral blood lymphocytes.

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Detection of Submicroscopic Lymph Node Metastases with Polymerase Chain Reaction in Patients with Malignant Melanoma

Cited by 258 publications

References 20 publications

Current Status of Sentinel Lymph Node Mapping and Biopsy: Facts and Controversies

Current Status of Sentinel Lymph Node Mapping and Biopsy: Facts and Controversies

Detection of regional melanoma metastases by ultrasound B-scan, cytology or tyrosinase RT-PCR of fine-needle aspirates

Limitations of the nested reverse transcriptase polymerase chain reaction on tyrosinase for the detection of malignant melanoma micrometastases in lymph nodes

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