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Prognostic Value of Tyrosinase Reverse-transcriptase Polymerase Chain-reaction in Peripheral Blood of Uveal Melanoma Patients
Flögel I., Langmann G., Müllner K., El-Shabrawi Y.,
Karl-Franzens-Universität Graz, Augenklinik (Graz)
Purpose: Fourty to fifty percent of all patients with uveal melanoma die of systemic metastatic disease. Tyrosinase-based reverse transcriptase polymerase chain reaction (RT-PCR) is described to be a method for the detection of circulating tumour cells in the blood. No longterm studies about the the prognostic impact for tyrosinase PCR in uveal melanoma have been reported.
Method: In 45 patients with uveal malignant melanoma RT-PCR for tyrosinase was performed before and after therapy. A clinical follow up was performed for each patient for at least five years including chest x-ray, serum liver enzyme determination, liver scan and bone szintigraphy. PCR results, tumour localization, tumour size, treatment, histopathology and systemic metastatic diesease were analysed.
Results: 82% of the PCR samples, that had shown a postive result prior to therapy revealed a negative result after therapy. A correlation between 5 year survival and positive result of the PCR could not be established.
Conclusion: Tyrosinase PCR is known to be a sensitive method for detection of tumorcells in systemic circulation. Our results though question the prognostic value of this method. One of the possible reasons of no correlation between positive RT-PCR and distant metastases might be that the peripheral spreading of tumor cells is just one of the determining factors - among many others - for the development of distant metastases. This study indicates that presence of tumor cells in peripheral blood does not correlate with development of distant metastases.