METHODS: This study included 100 stage III melanoma patients in follow-up after curative lymph node dissection. Follow-up visits included physical examination and S-100B monitoring. FDG PET/CT scanning was indicated by clinical symptoms and/or elevated S-100B.
RESULTS: Of 100 patients, 13 (13%) had elevated S-100B without clinical symptoms, of whom 7 (54%) showed disease evidence upon FDG PET/CT scanning. Twenty-six patients (26%) had clinical symptoms with normal S-100B and FDG PET/CT revealed metastasis in 20 (77%). Three patients had clinical symptoms and elevated S-100B, and FDG PET/CT revealed metastasis in all three (100%). Overall, FDG PET/CT scanning revealed metastasis in 30 of the 42 patients (71.4%). For seven recurrences, elevated S-100B prompted early detection of asymptomatic disease; 10% of all asymptomatic patients in follow-up, 23% of all patients with recurrent disease.
CONCLUSIONS: S-100B cannot exclude recurrent disease during follow-up of stage III melanoma. However, adding S-100B measurement to standard clinical assessment can guide FDG PET/CT scanning for detecting recurrent melanoma.
方法:本研究纳入了100名III期黑色素瘤患者,在根治性淋巴结清扫术后随访。随访包括体格检查和S-100B监测。FDGPET/CT扫描显示临床症状和/或S-100B升高。
结果:在100名患者中,13例(13%)S-100B升高,无临床症状,其中7人(54%)在FDGPET/CT扫描时显示疾病证据。26例(26%)有正常S-100B和FDGPET/CT的临床症状,20例(77%)有转移。3例患者出现临床症状和S-100B升高,和FDGPET/CT均显示转移(100%)。总的来说,FDGPET/CT扫描显示42例患者中有30例(71.4%)转移。对于七次复发,升高的S-100B促使早期发现无症状疾病;所有无症状患者中有10%在随访中,23%的全体患者具有复发性疾病。
结论:S-100B不能排除III期黑色素瘤随访期间的复发性疾病。然而,在标准临床评估中加入S-100B测量可以指导FDGPET/CT扫描检测复发性黑色素瘤.