Differential Scanning Calorimetry, as a New Method to Monitor Human Plasma in Melanoma Patients with Regional Lymph Node or Distal Metastases

Abstract

Cutaneus malignant melanoma (MM) is a highly malignant tumour of the skin and is responsible for more deaths than any other skin cancer (Imko-Walczuk et al., 2009). Melanocytes originate from the neural crest and in contrast to Langerhans' cells are located amongst the basal layer of the epidermis, hair bulb, eyes, ears, and meninges (Bandarchi et al., 2010; Fitzpatrick, 1971; Nordlund & Boissy, 2001). The pigmentary system of the skin is a complex set of reactions with many potential sites for dysfunction (Grichnik, 1998). Melanin pigment is produced by melanocytes in their specific cytoplasmic organelles called melanosomes. MM arises from the malignant transformation of melanocytes at the dermalepidermal junction or from the nevomelanocytes of melanocytic nevi that become invasive and may metastasise. The incidence of MM has been increasing in white populations. Although MM comprises less than 5% of malignant skin tumours; however, it is responsible for almost 60% of lethal skin neoplasia. With increased life expectancy of the elderly population, melanoma will be a public health challenge (Riker et al., 2010). Increased incidence of melanoma is partly due to early detection (thin melanomas) and partly due to true increase of incidence. Despite the increase in the incidence of melanoma, the prognosis has been improving due to earlier diagnosis of thin melanomas and hence in a curable stage (MacKie, 2000). The incidence of melanoma is equal in men and women and uncommon in children although there are reports that the incidence may be higher in women. A typical patient is usually a Caucasian adult in the 4th decade of life with lesion on the back and leg in male and female, respectively. One typical study revealed that the most common sites in decreasing order are the trunk (43.5%), extremities (33.9%), acral sites (11.9%), and head and neck (10.7%) (Bandarchi et al., 2010). There is a complex interaction of environmental (exogenous) and endogenous factors. Up to 65% of MM is sun-related (Whiteman & Green, 1999). It is now widely accepted that the major environmental risk factor for the development of primary cutaneous melanoma is Ultraviolent (UV) radiation, which can be subdivided into UVA, UVB, and UVC. UV radiation in sunlight is cytotoxic and, in over dosages, clearly detrimental cells die in