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Imaging, Diagnosis, Prognosis

Visualization of Circulating Melanoma Cells in Peripheral Blood of Patients with Primary Uveal Melanoma

Anja Ulmer, Julia Beutel, Daniela Süsskind, Ralf-Dieter Hilgers, Focke Ziemssen, Matthias Lüke, Martin Röcken, Martin Rohrbach, Gerhard Fierlbeck, Karl-Ulrich Bartz-Schmidt and Salvatore Grisanti
Anja Ulmer
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Julia Beutel
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Daniela Süsskind
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Ralf-Dieter Hilgers
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Focke Ziemssen
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Matthias Lüke
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Martin Röcken
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Martin Rohrbach
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Gerhard Fierlbeck
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Karl-Ulrich Bartz-Schmidt
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Salvatore Grisanti
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DOI: 10.1158/1078-0432.CCR-08-0012 Published July 2008
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    Fig. 1.

    Blue immunostaining of MCSP-positive tumor cells in peripheral blood of patients with primary uveal melanoma (A-C). Surrounding lymphocytes (B) and granulocytes enriched from peripheral blood of a healthy volunteer (D) do not express the antigen (5-bromo-4-chloro-3-indoyl phosphate and nitroblue tetrazolium, alkaline phosphatase–anti-alkaline phosphatase; original magnification, ×400).

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  • Table 1.

    Association of established clinical prognostic markers with the presence of circulating tumor cells

    VariablePositive for CTC (n = 10)Negative for CTC (n = 42)All patients (N = 52)POR (95% Wald confidence limits)
    Age (y)
        Median7264650.83681.0 (1.0, 1.1)
        Min, max18, 8126, 8218, 82
    Sex
        Female621270.57101.5 (0.4, 6.1)
        Male42125
    LBD (mm)*
        Median16.1511.5112.20.0030†NA
        Min, max10.12, 19.274.22, 23.04.22, 23, 0
        >14610160.00651.4 (1.1, 1.8)
        <1443135
    Tumor height (mm)
        Median8.846.877.760.0249†NA
        Min, max4.65, 13.01.3, 18.01.3, 18, 0
    Ciliary body infiltration
        Yes5270.001820.0 (3.0, 131.7)
        No54045
    Localization
        Anterior4150.02064.0 (1.2, 12.7)
        Peripheral32023
        Posterior32124
    • NOTE: All tests are based on fitting a univariate logistic regression model (Wald χ2 test) except for median tumor height and LBD, which were analyzed using the Wilcoxon rank sum test.

      Abbreviations: CTC, circulating tumor cells; n, number; min, minimum; max, maximum; mm, millimeter; LBD, largest basal diameter; NA, not applicable.

    • ↵* Missing data: n = 1.

    • ↵† Analyzed using the Wilcoxon rank sum test.

  • Table 2.

    Association between tumor stage according to TNM 6th edition (A) and modified Augsburger classification no. 1 (B) with the presence of circulating tumor cells

    A
    TNM 6th edition*No. pts examinedNo. pts positivePositivity rate, % (95% CI)
    T1N0M0LBD ≤ 10 mm and height ≤ 2.5 mm regardless of extraocular extension1500.0 (0.0-18.0)
    T2N0M010 < LBD ≤ 16 mm and/or 2.5 < height ≤ 10 mm regardless of extraocular extension30517.0 (6.0-35.0)
    T3N0M0LBD > 16mm and/or height >10 mm without extraocular extension5480.0 (28.0-99.0)
    T4N0M0LDB > 16 mm and/or height > 10 mm with extraocular extension2150.0 (1.0-99.0)
    B

    Modified Augsburger alternative classification no. 1, ciliary body and choroid*
    No. pts examined
    No. pts positive
    Positivity rate, % (95% CI)
    T1N0M0LBD ≤ 10 mm and height ≤ 5 mm regardless of extraocular extension1300.0 (0.0-21.0)
    T2N0M010 < LBD ≤ 15 mm and/or 5 < height ≤ 8 mm regardless of extraocular extension2015.0 (0.0-25.0)
    T3N0M0LBD > 15 mm and/or height > 8 mm without extraocular extension17847.0 (23.0-72.0)
    T4N0M0LBD > 15 mm and/or height > 8 mm with extraocular extension2150.0 (1.0-99.0)
    • NOTE: All 95% CI values are Clopper Pearson confidence intervals except for the data in bold, which are confidence intervals for zero events.

      Abbreviations: T, tumor stage; no., number; pts, patients; height, tumor height, LBD, largest basal diameter.

    • ↵* See ref. 4.

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Clinical Cancer Research: 14 (14)
July 2008
Volume 14, Issue 14
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Visualization of Circulating Melanoma Cells in Peripheral Blood of Patients with Primary Uveal Melanoma
Anja Ulmer, Julia Beutel, Daniela Süsskind, Ralf-Dieter Hilgers, Focke Ziemssen, Matthias Lüke, Martin Röcken, Martin Rohrbach, Gerhard Fierlbeck, Karl-Ulrich Bartz-Schmidt and Salvatore Grisanti
Clin Cancer Res July 15 2008 (14) (14) 4469-4474; DOI: 10.1158/1078-0432.CCR-08-0012

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Visualization of Circulating Melanoma Cells in Peripheral Blood of Patients with Primary Uveal Melanoma
Anja Ulmer, Julia Beutel, Daniela Süsskind, Ralf-Dieter Hilgers, Focke Ziemssen, Matthias Lüke, Martin Röcken, Martin Rohrbach, Gerhard Fierlbeck, Karl-Ulrich Bartz-Schmidt and Salvatore Grisanti
Clin Cancer Res July 15 2008 (14) (14) 4469-4474; DOI: 10.1158/1078-0432.CCR-08-0012
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