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

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

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