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. 2014 Apr;31(4):407-21.
doi: 10.1007/s10585-014-9636-7. Epub 2014 Jan 17.

Surface antigen profiles of leukocytes and melanoma cells in lymph node metastases are associated with survival in AJCC stage III melanoma patients

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Surface antigen profiles of leukocytes and melanoma cells in lymph node metastases are associated with survival in AJCC stage III melanoma patients

Kimberley L Kaufman et al. Clin Exp Metastasis. 2014 Apr.

Abstract

There is an urgent need to identify more accurate prognostic biomarkers in melanoma patients, particularly in those with metastatic disease. This study aimed to identify melanoma and leukocyte surface antigens predictive of survival in a prospective series of AJCC stage IIIb/c melanoma patients (n = 29). Live cell suspensions were prepared from melanoma metastases within lymph nodes (LN). The suspensions were immuno-magnetically separated into CD45(+) (leukocyte) and CD45(-) (non-hematopoietic, enriched melanoma cell) fractions. Surface antigens on CD45(-) and CD45(+) cell populations were profiled using DotScan™ microarrays (Medsaic Pty. Ltd.) and showed differential abundance levels for 52 and 78 antigens respectively. Associations of the surface profiles with clinicopathologic and outcome data (median follow-up 35.4 months post LN resection) were sought using univariate (log-rank test) and multivariate (Wald's test; modelled with patient's age, gender and AJCC staging at LN recurrence) survival models. CD9 (p = 0.036), CD39 (p = 0.004) and CD55 (p = 0.005) on CD45(+) leukocytes were independently associated with distant metastasis-free survival using multivariate analysis. Leukocytes with high CD39 levels were also significantly associated with increased overall survival (OS) in multivariate analysis (p = 0.016). LNs containing leukocytes expressing CD11b (p = 0.025), CD49d (p = 0.043) and CD79b (p = 0.044) were associated with reduced OS on univariate analysis. For enriched melanoma cells (CD45(-) cell populations), 11 surface antigens were significantly correlated with the disease-free interval (DFI) between diagnosis of culprit primary melanoma and LN metastasis resection. Nine antigens on CD45(+) leukocytes also correlated with DFI. Following validation in independent datasets, surface markers identified here should enable more accurate determination of prognosis in stage III melanoma patients and provide better risk stratification of patients entering clinical trials.

Keywords: Antibody microarray; CD antigen; Metastatic melanoma; Prognosis; Survival.

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Figures

Fig. 1
Fig. 1
Immuno-phenotypes of cell suspensions isolated from lymph node tumors resected from stage III metastatic melanoma patients. a Antibody key for the microarray, printed in duplicate on nitrocellulose slides. Antibody key is zone framed in grey on (bg). (bd) Antibody binding patterns of enriched melanoma cells (CD45) from patients 19, 13 and 8 respectively. (eg) Antibody binding patterns of leukocytes attached to CD45+ magnetic beads (CD45+) isolated from patients 19, 25 and 7 respectively. The numbers in (a) refer to antibodies against corresponding CD antigens; IgG1, IgG2a, IgG2b, IgG3 and IgM are murine isotype control antibodies tested at the concentrations shown in μg/mL; TCR α/β, TCR γ/δ, HLA-DR, FMC7, k and λ are antibodies against T-cell receptors α/β and γ/δ, HLA-DR, FMC-7, kappa and lambda immunoglobulin light chains, respectively. A border of CD44/CD29 alignment dots is shown around the duplicate microarrays of (bg)
Fig. 2
Fig. 2
Univariate cox proportional hazard models were used to evaluate associations between surface antigen levels and distant metastasis-free survival (DMFS). For graphical representation, plotted variables were dichotomized based on median antigen levels, 0 = low, 1 = high. Increased levels of (a) CD9 on CD45+ leukocytes were significantly associated with with distant metastasis and poor survival outcomes. Conversely, higher levels of (b) CD39 and (c) CD55 on CD45+ leukocytes were associated with DMFS
Fig. 3
Fig. 3
Univariate cox proportional hazard models were used to evaluate associations between surface antigen levels and overall survival (OS). For graphical representation, plotted variables were dichotomized based on median antigen levels, 0 = low, 1 = high. Increased levels of (a) CD11b, (b) CD79b and (c) CD49d on CD45+ leukocytes were significantly associated with reduced overall survival, whereas higher levels of (d) CD39 was associated with increased survival
Fig. 4
Fig. 4
Western blot verifying increased CD55 on CD45+ leukocytes fractionated from Stage III metastatic melanoma patients with distant metastasis-free survival (HR = 2.8; p = 0.008). Succinate dehydrogenase subunit A (SDHA) and total protein stains were used as loading controls

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