Value of tumour marker S-100B in melanoma patients: a comparison to 18F-FDG PET and clinical data

M. J. Reinhardt; J. Kensy; J. P. Frohmann; P. Willkomm; U. Reinhold; F. Grünwald; H.-J. Biersack; H. Bender

doi:10.1055/s-0038-1623884

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2002; 41(03): 143-147
DOI: 10.1055/s-0038-1623884

Original Article

Schattauer GmbH

Value of tumour marker S-100B in melanoma patients: a comparison to ¹⁸F-FDG PET and clinical data

Nutzen des Tumormarkers S-100B bei Melanompatienten: Vergleich mit ¹⁸F-FDG-PET und klinischen Daten

M. J. Reinhardt

¹Department of Nuclear Medicine (Head: Prof. Dr. H.-J. Biersack)

,

J. Kensy

¹Department of Nuclear Medicine (Head: Prof. Dr. H.-J. Biersack)

,

J. P. Frohmann

²Dermatology (Head: Prof. Dr. T. Bieber), University Hospital Bonn

,

P. Willkomm

¹Department of Nuclear Medicine (Head: Prof. Dr. H.-J. Biersack)

,

U. Reinhold

²Dermatology (Head: Prof. Dr. T. Bieber), University Hospital Bonn

,

F. Grünwald

³Department of Nuclear Medicine (Prof. Dr. F. Grünwald), University Hospital Frankfurt, Frankfurt, Germany

,

H.-J. Biersack

¹Department of Nuclear Medicine (Head: Prof. Dr. H.-J. Biersack)

,

H. Bender

¹Department of Nuclear Medicine (Head: Prof. Dr. H.-J. Biersack)

› Author Affiliations

Abstract

Summary

Aim: The S-100B protein is commonly used in the immunohistochemical diagnosis of malignant melanoma and its metastases and has recently been introduced as a tumor marker in peripheral blood, whereas ¹⁸F-FDG PET is currently the most sensitive in-vivo imaging method for melanoma staging. Thus, the efficency of serum S-100B and ¹⁸F-FDG PET in the detection of metastatic disease in melanoma patients are compared. Methods: Serum S-100B was measured with a commercially available immunoradiometric assay. As part of primary tumour staging whole-body positron emission tomography (PET) with ¹⁸F labeled fluorodeoxy-D-glucose (¹⁸F-FDG) was performed in 67 patients suffering from cutaneous melanoma with a tumour thickness > 0.75 mm and a Clark-level III-V. Final diagnosis based on histology, morphologic imaging results and/or clinical follow-up after at least six months. Results: No evidence of disease was seen in 43 of 67 patients (64.2%), 11 patients (16.4%) presented with lymph node metastases, 13 patients (19.4%) had one or more distant metastases. Alltogether, 18 of 67 patients showed S-100B values > 0.2 µg/l, including two patients without metastatic disease, 3 of 11 patients with lymph node metastases, and the 13 patients with distant metastases. One patient showed false-positive FDG-uptake in the mediastinum, but presented with S-100B values off curve. Conclusion: Our data indicate that serum S-100B determination might be helpful in identifying melanoma patients with distant metastases. In comparison to ¹⁸F-FDG PET, the value of serum S-100B for lymph-node staging is limited.

Zusammenfassung

Ziel: Das S-100B-Protein wird üblicherweise zur immunhistochemischen Diagnose von malignen Melanomen und Melanommetastasen verwendet. Kürzlich wurde es als Tumormarker im peripheren Blut eingeführt. Die ¹⁸F-FDG-PET ist das zurzeit sensitivste In-vivo-Bildgebungsverfahren zum Staging von Melanomen. In dieser Untersuchung wurde der Stellenwert von S-100B und ¹⁸F-FDG-PET zur Detektion von Metastasen bei Melanompatienten verglichen. Methoden: Die Serum-konzentration von S-100B wurde mit einem kommerzi-ellen immunradiometrischen Assay bestimmt. Als Teil des Primärstagings wurde bei 67 Patienten mit kutanem malignen Melanom der Tumortiefe > 0,75 mm und einem Clark-Level von III bis V eine Ganzkörper-Positronenemissionstomographie (PET) mit ¹⁸F-markierter Fluordeoxy-D-glukose (¹⁸F-FDG) durchgeführt. Die endgültige Diagnose basierte auf der Histologie, Ergebnissen der morphologischen Bildgebung und/oder dem klinischen Verlauf über mindestens sechs Monate. Ergebnisse: Von 67 Patienten zeigten 43 (64,2%) keinen Anhalt für ein Tumorgeschehen, 11 Patienten (16,4%) hatten Lymphknotenmetastasen und 13 Patienten (19,4%) eine oder mehr Fernmetastasen. Bei insgesamt 18 von 67 Patienten war die S-100B-Konzent-ration >0,2 µg/l. Dies umfasste 2 Patienten ohne Tumorgeschehen, 3 von 11 mit Lymphknotenmetastasen und die 13 mit Fernmetastasen. Ein Patient zeigte einen falsch positiven FDG-Uptake im Mediastinum, wies aber einen normalen S-100B-Wert auf. Schlussfolgerung: Die vorliegenden Daten sprechen dafür, dass die Bestimmung der S-100B-Serumkonzent-ration zur Identifikation von Melanompatienten mit Fernmetastasen hilfreich ist. Im Vergleich zur ¹⁸F-FDGPET ist der Stellenwert von Serum S-100B zum Lymph-knotenstaging begrenzt.

Keywords

S-100B protein - ¹⁸F-FDG PET - malignant melanoma

Schlüsselwörter

S-100B-Protein - 18F-FDG-PET - malignes Melanom

Full Text

References

References
1 Abraha HD, Fuller LC, Du Vivier AW. et al. Serum S-100 protein: a potentially useful prognostic marker in cutaneous melanoma. Br J Dermatol 1997; 137: 381-5.
2 Argenyi ZB, Cain C, Bromley C. et al. S-100 protein-negative malignant melanoma: fact or fiction? A light-microscopic and immunohisto-chemical study. Am J Dermatopathol 1994; 16: 233-40.
3 Armstrong BK, Kricker A. Cutaneous melanoma. Cancer Surveys 1994; 19: 219-40.
4 Balch CM, Reintgen DS, Kirkwood JM. et al. Cutaneous melanoma. In: De Vita VT, Hellman S, Rosenberg SA. (eds). Cancer. Principles and practice of oncology, 5^th ed. Philadelphia, New York: Lippincott-Raven; 1997: 1947-94.
5 Bender H, Kirst J, Palmedo H. et al. Value of 18-fluoro-deoxyglucose positron emission tomography in the staging of recurrent breast carcinoma. Anticancer Res 1997; 17: 1687-92.
6 Breslow A. Thickness, cross-sectional areas and depth of melanoma in the prognosis of cutaneous melanoma. Ann Surg 1970; 72: 902-8.
7 Clark WH. Tumor progression and the nature of cancer. Br J Cancer 1991; 64: 631-44.
8 Crowley NJ, Seigler HF. Late recurrence of malignant melanoma. Ann Surg 1990; 212: 173-7.
9 Day Jr CL, Lew RA, Mihm Jr MC. et al. The natural break points for primary-tumor thickness in clinical stage I melanoma. N Engl J Med 1981; 305: 1155.
10 Dietlein M, Krug B, Groth W. et al. Positron emission tomography using ¹⁸F-fluorodeoxyglucose in advanced stages of malignant melanoma: a comparison of ultrasonographic and radiological methods of diagnosis. Nucl Med Comm 1999; 20: 255-61.
11 Djukanovic D, Hofmann U, Sucker A. et al. Comparison of S 100 protein and MIA protein as serum marker for malignant melanoma. Anticancer Res 2000; 20: 2203-7.
12 Eigtved A, Andersson AP, Dahlstrom K. et al. Use of fluorine-18 fluorodeoxyglucose positron emission tomography in the detection of silent metastases from malignant melanoma. Eur J Nucl Med 2000; 27: 70-5.
13 Elwood JM, Koh HK. Etiology, epidemiology, risk factors, and public health issues of melanoma. Curr Op Oncol 1994; 6: 179-87.
14 Guo HB, Stoffel-Wagner B, Bierwirth T. et al. Clinical significance of serum S-100 in metastatic malignant melanoma. Eur J Cancer 1995; 31: 924-8.
15 Hansson LO, von Schoultz E, Djureen E. et al. Prognostic value of serum analyses of S-100 protein beta in malignant melanoma. Anticancer Res 1997; 17: 3071-3.
16 Henze G, Dummer R, Joller-Jemelka HI. et al. Serum S-100 – a marker for disease monitoring in metastatic melanoma. Dermatology 1997; 194: 208-12.
17 Houghton AN, Eisinger M, Albino AP. Surface antigens of melanocytes and melanomas. Markers of melanoma differentiation and melanoma subsets. J Exp Med 1982; 156: 1755-66.
18 Juergensen A, Holzapfel U, Hein R. et al. Comparison of two prognostic markers for malignant melanoma: MIA and S 100 beta. Tumor Biol 2001; 22: 54-8.
19 Kaskel P, Berking C, Sander S. et al. S-100 protein in peripheral blood: a marker for melanoma metastases: a prospective 2-center study of 570 patients with melanoma. J Am Acad Dermatol 1999; 41: 962-9.
20 Kath R, Jambrosic JA, Holland L. et al. Development of invasive and growth factor independent cell variants from primary human melanomas. Cancer Res 1991; 51: 2205-11.
21 Klein M, Freedman N, Lotem M. et al. Contribution of whole body F-18-FDG-PET and lymphoscintigraphy to the assessment of regional and distant metastases in cutaneous malignant melanoma. A pilot study. Nuklearmedizin 2000; 39: 56-61.
22 Lynch HT, Frichot BC, Lynch JF. Familial atypical multiple mole-melanoma syndrome. J Med Genet 1978; 15: 352-6.
23 Martenson ED, Hansson LO, Nilsson B. et al. Serum S-100B protein as prognostic marker in malignant cutaneous melanoma. J Clin Oncol 2001; 19: 824-31.
24 Mruck S, Baum RP, Rinne D. et al. Diagnostic accuracy and predictive value of tumor-associated antigen S 100 in malignant melanomas: validation by whole body FDG-PET and conventional diagnostics. Anticancer Res 1999; 19: 2685-90.
25 Paquet P, Hustinx R, Rigo P. et al. Malignant melanoma staging using whole-body positron emission tomography. Melanoma Res 1998; 8: 59-62.
26 Reske SN, Kotzerke J. FDG-PET for clinical use. Eur J Nucl Med 2001; 28: 1707-23.
27 Rettenbacher L, Koller J, Kässmann H. et al. Detection of melanoma metastases with Tc-99m-tetrofosmin. Nuklearmedizin 2000; 39: 97-101.
28 Rinne D, Baum RP, Hör G. et al. Primary staging and follow-up of high risk melanoma patients with whole-body 18F-fluorodeoxyglucose positron emission tomography: results of a prospective study of 100 patients. Cancer 1998; 82: 1664-71.
29 Schmitz C, Brenner W, Henze E. et al. Comparative study on the clinical use of protein S-100B and MIA (melanoma inhibitory activity) in melanoma patients. Anticancer Res 2000; 20: 5059-63.
30 Steinert HC, Huch-Buoni RA, Buck A. et al. Malignant melanoma: staging with whole-body positron emission tomography and 2-[F-18]-fluoro-2-deoxy-D-glucose. Radiology 1995; 195: 705-9.
31 Steinert HC, Voellmy DR, Trachsel C. et al. Planar coincidence scintigraphy and PET in staging malignant melanoma. J Nucl Med 1998; 39: 1892-7.
32 von Schoultz E, Hansson LO, Djureen E. et al. Prognostic value of serum analyses of S-100 beta protein in malignant melanoma. Melanoma Res 1996; 6: 133-7.
33 Wagner JD, Schauwecker D, Hutchins G. et al. Initial assessment of positron emission tomography for detection of nonpalpable regional lymphatic metastases in melanoma. J Surg Oncol 1997; 64: 181-9.