Dissertations
Micrometastasis in Malignant Melanoma
RAGNAR SOLBERG FAYE
Institute of Clinical Medicine, University of Oslo and Oslo University Hospital, NO-0424 Oslo, Norway. E-mail: ragfay@ous-hf.no
Ragnar Solberg Faye defended his PhD thesis on April 25, 2013, titled “Micrometastasis in malignant melanoma”, at the University of Oslo. Opponents and members of the evaluation committee were Olle Larkö,
Gothenburg, Olbjørn Klepp, Trondheim, and Stein Olav Kvaløy, Oslo. Main supervisors were Steinar Aamdal
and Øystein Fodstad.
Malignant melanoma is a malignant tumour arising from
melanocytes, primarily in the skin. In 2009, 1,413 new cases
of cutaneous malignant melanoma were diagnosed in Norway.
Approximately 20–25% of the patients will develop metastasis
and die. Extracutaneous malignant melanoma, including ocular
malignant melanoma, is rare, but is often diagnosed very late,
resulting in a poor prognosis. The diagnosis of malignant melanoma is based on histological examination of excision specimen.
Isolated malignant melanoma cells and malignant melanoma
cell deposits may be detected in the blood and/or bone marrow
of patients with malignant melanoma, using several methods,
including immunocytochemical methods and molecular detection methods. Detection of micrometastatic tumour cells
has been found to be associated with disease aggressiveness
in several forms of cancer.
Our aims were to detect malignant tumour cells in bone marrow and peripheral blood from cutaneous and uveal malignant
melanoma patients by an immunomagnetic detection method,
to compare the results with immunocytochemical examinations of cyt ospins, and to analyse the prognostic signi?cance
of such ?ndings. Also, we wanted to investigate S100B levels
in bone marrow from malignant melanoma patients and its
relation to prognosis, as well as in healthy individuals.
A signi?cant number of patients with cutaneous (19%) and
uveal (30%) malignant melanoma had detectable tumour cells
in the bone marrow (1, 2). In patients with cutaneous malignant
melanoma, presence of melanoma cells in the bone marrow
was a predictor for survival, both from time of testing and from
time of excision of the primary tumour (1).
Ragnar Solberg Faye defended his PhD thesis. From left to right: Olbjørn
Klepp (Opponent 2), Stein Olav Kvaløy (member of the evaluation
committee), Petter Gjersvik (Acting Dean), Olle Larkö (Opponent 1),
and Ragnar Solberg Faye. Photo: Private.
In conclusion, malignant tumour cells are frequently present
in the bone marrow in cutaneous and uveal malignant melanoma patients. Detection of bone marrow micrometastasis
has prognostic signi?cance in cutaneous malignant melanoma
patients. S100B levels are higher in the bone marrow than in
peripheral blood, the signi?cance of which is unclear. Detection of micrometastasis by immunomagnetic methods in the
bone marrow in patients with malignant melanoma may
become important to identify patients with poor prognosis
and to select candidates for more aggressive adjuvant treatment and follow-up.
References
1.
Median S100B protein levels in bone marrow aspirates from
female malignant melanoma patients and from healthy female
volunteers were more than 40 times higher than the recommended cut-off value for S100B protein in peripheral blood
(3). We found no signi?cant difference between the levels of
S100B in bone marrow from malignant melanoma patients
and healthy volunteers. The median S100B level in the bone
marrow samples from male melanoma patients was nearly
three times higher than for female melanoma patients.
Forum for Nord Derm Ven 2013, Vol. 18, No. 4
2.
3.
Faye RS, Aamdal S, Høifødt HK, Jacobsen E, Holstad L, Skovlund
E, Fodstad Ø. Immunomagnetic detection and clinical signi?cance
of micrometastatic tumor cells in malignant melanoma patients.
Clin Cancer Res 2004; 10: 4134–4139.
Eide N, Faye RS, Høifødt HK, Øvergaard R, Jebsen P, Kvalheim G,
Fodstad Ø. Immunomagnetic detection of micrometastatic cells
in bone marrow in uveal melanoma patients. Acta Ophthalmol
2009; 87: 830–836.
Faye RS, Paus E, Mælandsmo GM, Berner A, Høifødt HK, Fodstad
Ø, Aamdal S. S100B in bone marrow aspirates in healthy individuals and malignant melanoma patients. Melanoma Res 2008; 18:
134–140.
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