Can CD2 predict survival and recurrence in patients with stage II to III melanoma?

The authors aim was to determine whether CD2 could be a good indicator of survival in stage II to III cutaneous melanoma patients. 

Patients with stage II or III melanoma have a survival rate that varies from 24% to 70%. This wide range of survival rates occurs as the melanoma may spread microsopically (not visible to the naked eye) before primary lesion resection (removal of cancerous tissue) has been carried out. This undetected spread is known as micrometastasis where the tumors are too small to detect and spread out from the primary site into other sites of the body.

CD2 is a type of protein that fights disease. It is found on immune cells and detects and removes foreign objects in the body, for example, cancer cells. When the immune cells are fully active, a lot of CD2 is produced. It is suggested that high levels of CD2 could therefore be a predictor of an active immune system, and by extension may predict stage II and III melanoma recurrence (return of melanoma after surgery).

The aim of this study was to determine the significance of CD2 as a predictor in stage II and III melanoma survival and recurrence.

Samples were obtained from 90 patients with stage II or III primary melanoma. 59 patients were male and elderly with an average age of 69 years. The average depth (how deep into the skin layers the cancer goes) of the primary melanoma was 3mm. In total 59 patients had stage II melanoma and 31 patients had stage III. 45 patients experienced disease recurrence in an average time of 13.5 months.

CD2 levels were significantly increased in primary melanoma samples from non-recurrent patients compared to recurrent patients. In recurrent patients the average CD2 level was 75.6 cells per sample, while the average CD2 level in patients who subsequently developed disease recurrence was 37.5 cells per sample.

Patients with low CD2 levels were twice as likely to develop recurrent disease. High levels of CD2 predicted a negative sentinel lymph node (no cancer in the first lymph node tested for cancer) and demonstrated an overall superior survival compared to lower levels.

There was a noticeable decrease in CD2 levels in patients with stage III melanoma compared to those with stage II, which correlated with a decrease in overall survival.

High levels of CD2 can be used as a potential indicator of non-recurrence and prolonged survival in patients with stage II and III primary melanoma.

Reporting standards and follow-up guideline were mixed throughout the patient population so potentially the results can not be applied to all individuals. 

If interested in determining likelihood of recurrence of melanoma, discuss with your doctor the feasibility of having your melanoma evaluated for CD2 levels.