S100 B - tumorski označevalec kožnega melanoma

Barbara Perić (Avtor), Ivana Žagar (Avtor), Srdjan Novaković (Avtor), Janez Žgajnar (Avtor), Marko Hočevar (Avtor)

Povzetek

Da bi pravočasno odkrili zasevke kožnega melanoma (KM), na Onkološkem inštitutu Ljubljana uporabljamo določanje serumske ravni tumorskega označevalca S100B. Če je raven zvišana, nadaljujemo s slikovnimi preiskavami, v zadnjih letih predvsem s PET-CT. S svojo raziskavo smo skušali pokazati, kako učinkovito je odkrivanje napredovale bolezni z določanjem serumskega S100 B in s PET-CT med rednim sledenjem bolnikov, ki imajo KM. Med septembrom 2007 in februarjem 2010 smo na PET-CT napotili 115 bolnikov s KM. Med njimi je bilo 82 (71,3 %) bolnikov s kliničnimi znaki bolezni in 33 (28,7 %) asimptomatskih bolnikov z 2 povečanima vrednostma serumskega S100 B. Z uveljavljenimi metodami smo izračunali občutljivost, specifičnost ter pozitivno in negativno napovedno vrednost (PNV, NNV) določanja S100 B in PET-CT. Zasevke smo odkrili pri 81,7 % bolnikov. Občutljivost, specifičnost, PNV in NNV S100 B so bili 33,8 %, 90,9 %, 96 % in 17,5 % pri bolnikih s kliničnimi znaki bolezni. Pri 20 % bolnikov so bile povečane serumske vrednosti S100 B edini znanilec zasevkov KM. Občutljivost in PNV S100 B v tej skupini bolnikov sta bila 100 % in 69,7 %. S PET-CT smo napredovalo bolezen potrdili pri 84,2 % bolnikov, ki so imeli klinično sliko napredovale bolezni, ter pri 72,7 % asimptomatskih bolnikov s povečanimi vrednostmi S100 B. Občutljivost, specifičnost, PNV in NNV PET-CT za bolnike s klinično sliko so bili 98,5 %, 90,9 %, 98,5 %, 90,9 % ter 100 %, 90 %, 95,8 % in 100 % pri asimptomatskih bolnikih s povečanimi vrednostmi S100 B. Redno spremljanje serumskega S100 B pri bolnikih s KM omogoča odkritje napredovale bolezni pri asimptomatskih bolnikih. Uspešnost metode je večja, če bolnike napotimo na PET-CT, kadar imajo povečane vrednosti S100 B.

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Podatki

Jezik:	Slovenski jezik
Leto izida:	2011
Tipologija:	1.03 - Kratki znanstveni prispevek
Organizacija:	OI - Onkološki inštitut Ljubljana
UDK:	616.5-006.6-076
COBISS:	1196411
ISSN:	1408-1741
Matična publikacija:	Onkologija
Št. ogledov:	2462
Št. prenosov:	616
Ocena:	0 (0 glasov)
Metapodatki:

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Sekundarni jezik:	Angleški jezik
Sekundarni naslov:	S100B – Tumor marker in cutaneous melanoma
Sekundarni povzetek:	Introduction. An increased level of serum S100B can serve as a marker of metastatic spread in patients with cutaneous melanoma (CM). In patients with elevated S100 B and/or clinical signs of disease progression, a PET-CT scan is a valuable tool for discovering metastases and planning treatment. The aims of this study were to determine whether regular measurements of serum S100B are a useful tool for identifying patients with CM metastases and for evaluating the diagnostic value of PET-CT during the follow-up. Methods. From September 2007 to February 2010, 115 CM patients included in regular follow up at the Institute of Oncology Ljubljana were appointed to receive PET-CT scans. They included 82 (71.3%) patients with clinical signs of disease progression and 33 (28.7%) asymptomatic patients with two subsequent elevated values of S100B. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) of S100B and PET-CT were calculated using standard procedures. Results. Disease progression was confirmed in 81.7% of the patients (in 86.5% of patients with clinical signs of disease progression and in 69.7% of asymptomatic patients with elevated S100B). Sensitivity, specificity, PPV and NPV of S100B was 33.8%, 90.9%, 96.0% and 17.5%, respectively, in patients with clinical signs of disease progression. For 20.0% of the patients increased serum S100B was the only sign of disease progression. Sensitivity and PPV of S100 in this group of patients were 100.0% and 69.7%, respectively. PET-CT disease progression was diagnosed in 84.2% of symptomatic patients and in 72.7% of asymptomatic patients with elevated S100B. The sensitivity, specificity, PPV and NPV of PET-CT for symptomatic patients was 98.5%, 90.9%, 98.5% and 90.9%, respectively, and 100%, 90.0%, 95.8% and 100%, respectively, for asymptomatic patients with elevated S100. Conclusions. Measurements of serum S100B during regular follow-up of patients with CM are a useful tool for discovering disease progression in asymptomatic patients. The value of its use increases if measurements are followed by extended whole body PET-CT.
Sekundarne ključne besede:	Skin neoplasms;Melanoma;Neoplasm metastasis;S100 proteins;Tomography, emission-computed;
URN:	URN:NBN:SI
Komentar vira:	Soavtorji: I. Žagar, S. Novaković, J. Žgajnar, M. Hočevar;
Strani:	str. 102-105
Letnik:	ǂLetn. ǂ15
Zvezek:	ǂšt. ǂ2
Čas izdaje:	dec. 2011
ID:	10956368