MYCN expression is not prognostic of adverse outcome in advanced-stage neuroblastoma with nonamplified MYCN
MYCN expression is not prognostic of adverse outcome in advanced-stage neuroblastoma with nonamplified MYCN
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DOI：
10.1200/jco.2000.18.21.3604
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发表时间：
2000-11-01
影响因子：
45.3
通讯作者：
Haber, M
中科院分区：
文献类型：
--
作者：
Cohn, SL;London, WB;Haber, M
目的：MYCN在儿童神经母细胞瘤（NB）中表达的临床意义仍存在争议。为了确定在没有MYCN扩增的情况下MYCN表达的预后意义，我们分析了69名患者肿瘤中的MYCN mRNA和蛋白质表达。患者和方法：从儿科肿瘤学小组神经母细胞瘤肿瘤库获得了69份来自C期或D期疾病患者的具有非扩增MYCN的NB肿瘤样本。MYCN mRNA采用实时逆转录聚合酶链反应分析，MYCN蛋白采用Western blot分析。结果：该队列的估计5年无事件生存率（EFS）和生存率（5）加SE分别为57% +/- 17%和60% +/-16%。小于1岁的婴儿EFS和S的发生率明显高于大于或等于1岁的儿童（分别为P = 0.003和P <0.001）; C期疾病患者的预后好于D期NE患者（P <0.001）;超二倍体肿瘤患者的预后好于二倍体NE患者（P <0.001）。令人惊讶的是，MYCN mRNA表达水平高的患者的结果略好于MYCN mRNA表达水平低的患者。（4年5，70% +/- 13% v50% +/- 16%; P = 0.290），以及表达MYCN蛋白的肿瘤患者（4年S，分别为73% +/-19%v53%+/-15%，P = 0.171）.结论：MYCN高水平表达不是伴有非扩增MYCN的晚期NE患者不良结局的预后因素。观察到高水平MYCN表达与改善结局相关的趋势。(C)2000年，美国临床肿瘤学会。
Purpose: The clinical significance of MYCN expression in children with neuroblastoma (NB) remains controversial. To determine the prognostic significance of MYCN expression in the absence of MYCN amplification, we analyzed MYCN mRNA and protein expression in tumors from 69 patients.Patients and Methods: Sixty-nine NB tumor samples with nonamplified MYCN from patients with stage C or D disease were obtained from the Pediatric Oncology Group Neuroblastoma Tumor Bank. MYCN mRNA was analyzed using a real-rime reverse transcriptase polymerase chain reaction assay, and MYCN protein was examined by Western blot analyses.Results: The estimated 5-year event-free survival (EFS) and survival (5) rates plus SE for the cohort were 57% +/- 17% and 60% +/- 16%, respectively. infants younger than 1 year had significantly higher rates of EFS and S than children greater than or equal to 1 year of age (P = .003 and P < .001, respectively); patients with stage C disease had better outcome than those with stage, D NE (P < .001); and patients with hyperdiploid tumors held better outcome than those with diploid NE (P < .001). Surprisingly, outcome war slightly better for patients with high versus low levels of MYCN mRNA expression (4-year 5, 70% +/- 13% v50% +/- 16%; P = .290), and for patients with tumors that expressed MYCN protein (4-year S, 73% +/- 19% v 53% +/- 15%, respectively; P = .171).Conclusion: High levels of MYCN expression are not prognostic of adverse outcome in patients with advanced-stage NE with nonamplified MYCN. A trend associating high levels of MYCN expression with improved outcome was observed. (C) 2000 by American Society of Clinical Oncology.