Validation of CP-GEP (Merlin Assay) for predicting sentinel lymph node metastasis in primary cutaneous melanoma patients: A U.S. cohort study.
Validation of CP-GEP (Merlin Assay) for predicting sentinel lymph node metastasis in primary cutaneous melanoma patients: A U.S. cohort study.
复制标题
DOI：
10.1111/ijd.15594
复制
发表时间：
2021-07
影响因子：
3.6
通讯作者：
Meves A
中科院分区：
文献类型：
--
作者：
Yousaf A;Tjien-Fooh FJ;Rentroia-Pacheco B;Quattrocchi E;Kobic A;Tempel D;Kolodney M;Meves A
大约85%接受前哨淋巴结活检（SLNB）的黑色素瘤患者为淋巴结阴性。≥65岁患者的黑色素瘤发病率最高，但其SLNB阳性率低于年轻患者。CP‐GEP是一种结合临床病理学和基因表达变量的模型，可识别原发性皮肤黑色素瘤（CM）患者，由于其淋巴结转移风险较低，因此可以安全地放弃SLNB。在这里，我们在美国黑色素瘤患者队列中验证了CP-GEP。我们使用了来自马约诊所和西弗吉尼亚大学的208例原发性CM成人患者。根据患者的淋巴结转移风险对患者进行分层：CP-GEP高风险和CP-GEP低风险。主要性能指标为SLNB减少率（RR）和阴性预测值（NPV）。整个队列的SLNB阳性率为21%。大多数患者患有T1 b（34%）或T2 a（31%）黑素瘤。在T1-T2组（153例患者）中，CP-GEP在NPV为93.8%（95% CI：84.8 - 98.3）时实现了41.8%（95% CI：33.9 - 50.1）的SLNB RR。亚组分析显示，≥65岁的T1-T2患者的性能相似（51例患者; SLNB阳性率，9.8%）：在NPV为95.5%（95% CI：77.2 - 99.9）时，SLNB RR为43.1%（95% CI：29.3 - 57.8）。我们证实了CP-GEP在所有相关年龄组中减少阴性SLNB的潜力。我们的研究结果与≥65岁的患者尤其相关，这些患者通常选择手术。CP-GEP可以指导临床实践中的SLNB决策。
Approximately 85% of melanoma patients who undergo a sentinel lymph node biopsy (SLNB) are node‐negative. Melanoma incidence is highest in patients ≥65 years, but their SLNB positivity rate is lower than in younger patients. CP‐GEP, a model combining clinicopathologic and gene expression variables, identifies primary cutaneous melanoma (CM) patients who may safely forgo SLNB due to their low risk for nodal metastasis. Here, we validate CP‐GEP in a U.S. melanoma patient cohort. A cohort of 208 adult patients with primary CM from the Mayo Clinic and West Virginia University was used. Patients were stratified according to their risk for nodal metastasis: CP‐GEP High Risk and CP‐GEP Low Risk. The main performance measures were SLNB reduction rate (RR) and negative predictive value (NPV). SLNB positivity rate for the entire cohort was 21%. Most patients had a T1b (34%) or T2a (31%) melanoma. In the T1‐T2 group (153 patients), CP‐GEP achieved an SLNB RR of 41.8% (95% CI: 33.9‐50.1) at an NPV of 93.8% (95% CI: 84.8‐98.3). Subgroup analysis showed similar performance in T1‐T2 patients ≥65 years of age (51 patients; SLNB positivity rate, 9.8%): SLNB RR of 43.1% (95% CI: 29.3‐57.8) at an NPV of 95.5% (95% CI: 77.2‐99.9). We confirmed the potential of CP‐GEP to reduce negative SLNB in all relevant age groups. Our findings are especially relevant to patients ≥65 years, where surgery is often elective. CP‐GEP may guide SLNB decision‐making in clinical practice.
登录
查看更多内容
DOI：
10.1016/j.mayocpiqo.2020.05.009
发表时间：
2020-10-01
期刊：
Mayo Clinic proceedings. Innovations, quality & outcomes
影响因子：
--
作者：
Meves, Alexander;Eggermont, Alexander M M
通讯作者：
Eggermont, Alexander M M
影响因子：
9
作者：
Mocellin, Simone;Thompson, John F.;Rossi, Carlo R.
通讯作者：
Rossi, Carlo R.
影响因子：
3.1
作者：
Schuurman, Melinda S.;Hollestein, Loes M.;Louwman, Marieke W. J.
通讯作者：
Louwman, Marieke W. J.
DOI：
10.3322/caac.21409
发表时间：
2017-11
期刊：
CA: a cancer journal for clinicians
影响因子：
--
作者：
Gershenwald JE;Scolyer RA;Hess KR;Sondak VK;Long GV;Ross MI;Lazar AJ;Faries MB;Kirkwood JM;McArthur GA;Haydu LE;Eggermont AMM;Flaherty KT;Balch CM;Thompson JF;for members of the American Joint Committee on Cancer Melanoma Expert Panel and the International Melanoma Database and Discovery Platform
通讯作者：
for members of the American Joint Committee on Cancer Melanoma Expert Panel and the International Melanoma Database and Discovery Platform
DOI：
10.1111/bjd.19499
发表时间：
2021-05
期刊：
The British journal of dermatology
影响因子：
--
作者：
Mulder EEAP;Dwarkasing JT;Tempel D;van der Spek A;Bosman L;Verver D;Mooyaart AL;van der Veldt AAM;Verhoef C;Nijsten TEC;Grunhagen DJ;Hollestein LM
通讯作者：
Hollestein LM