cqvip:Detection of micrometastases in the regional tumor- draining lymph nodes is critical for staging and prognosis in melanoma patients. We applied a quantitative multiple- marker RT- PCR assay to improve the detection of occult melanoma cells in the sentinellymphnode (SLN). From 139 patients with primary cutaneous melanoma who underwent sentinel lymphadenectomy, a total of 235 SLN were assessed for Melan- A and tyrosinase expression by real- time quantitative RT- PCR. Twenty- three patients (17% ) were positive by histopathology and expressed messenger RNA of one or two markers. Of the patients with histopathologically negative SLN 39 (28% ) were reclassified by positive RT- PCR. Patients were examined for tumor recurrences during a median follow- up period of 29 mo. Tumor recurrences were demonstrated in eight patients (35% ) with histopathologically positive SLN, in four patients (10% ) with submicroscopic tumor cells detected exclusively by real- time RT- PCR, and in none of the patients negative by both methods. The differences in recurrence rates were statistically significant (P=0.01). These data indicate that real- time quantitative RTPCR for the detection of minimal residual melanoma in SLN improves the prediction of disease- free survival.
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