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Serummarker des malignen Melanoms

Serum markers for melanoma

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Zusammenfassung

Tumormarkerbestimmungen im Serum erkrankter Patienten haben einen hohen Stellenwert in der Diagnostik und Prognostik sowie in der Kontrolle von Erkrankungsverlauf und Therapieerfolg. Die momentan für das maligne Melanom zur Verfügung stehenden Marker sind nur eingeschränkt verwendbar. Ihre Hauptvertreter für den breiten klinischen Einsatz, S100β, MIA („melanoma inhibitory activity“) und LDH (Laktatdehydrogenase), korrelieren in ihrer Serumkonzentration stark mit der Tumorlast der Patienten. Die regelmäßige Bestimmung der S100β- bzw. MIA-Serumkonzentration in der Melanomnachsorge kann zur Früherkennung eines Rezidivs verwendet werden. Erhöhte Serumkonzentrationen sind ein Indikator für Tumorwachstum. Erhöhte Werte für S100β, MIA oder LDH sind mit einer ungünstigen Überlebensprognose fernmetastasierter Melanompatienten assoziiert. Bei dieser Patientengruppe können diese 3 Serummarker auch zur Beurteilung des Erkrankungsverlaufs und Therapieerfolgs eingesetzt werden. Aufgrund fehlender tumorlastunabhängiger Serummarker für das maligne Melanom ist eine prognostische Aussage hinsichtlich des Überlebens postoperativ tumorfreier Patienten derzeit nicht möglich. Auch zum Screening oder für die Diagnostik von Primärmelanomen sind Serummarker nicht einsetzbar.

Abstract

Tumor markers in the serum of cancer patients have an important role in clinical diagnosis and in prognosis, and also in the monitoring of the patients’ disease and response to therapy over time. The serum markers currently available for melanoma have only limited clinical use. Those most widely used in clinical applications are S100-beta, melanoma inhibitory activity, and lactate dehydrogenase; there are close correlations between the serum concentrations of these and tumor load. Regular determination of S100-beta and MIA levels during follow-up can therefore be used for early detection of a tumor relapse in melanoma patients, increased serum concentrations of these marker proteins being indicative of tumor growth. Patients with distant metastases from melanoma who present with elevated serum levels of S100-beta, MIA, or LDH have poorer overall survival than do patients whose serum concentrations are within normal ranges. These three markers can also be used to monitor the course of disease and therapy outcome in patients with distant metastases. Since there are no marker proteins for melanoma that are not dependent on tumor load, it is not currently possible to forecast the survival of patients who are tumor free after surgery. Serum markers are also not suitable for screening or for the diagnosis of primary melanomas.

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  1. Klinische Kooperationseinheit Dermato-Onkologie, Deutsches Krebsforschungszentrum Heidelberg/Universitätshautklinik Mannheim

    S. Ugurel

  2. Klinische Kooperationseinheit Dermato-Onkologie, Deutsches Krebsforschungszentrum Heidelberg/Universitätshautklinik Mannheim, Theodor-Kutzer-Ufer 1, 68167 , Mannheim

    S. Ugurel

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Ugurel, S. Serummarker des malignen Melanoms. Hautarzt 56, 173–186 (2005). https://doi.org/10.1007/s00105-004-0893-2

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