Experience with international neuroblastoma staging system and pathology classification
Experience with international neuroblastoma staging system and pathology classification
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DOI：
10.1038/sj/bjc/6600231
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发表时间：
2002-04-08
影响因子：
8.8
通讯作者：
Takamatsu, H
中科院分区：
文献类型：
--
作者：
Ikeda, H;Iehara, T;Takamatsu, H
国际神经母细胞瘤分期系统和病理分类分别于1988年和1999年提出，但其临床价值尚未在新患者中得到充分研究。1995年1月至1999年12月期间治疗的644例神经母细胞瘤患者进行了分析，这些分类。INSS分期1、2A、2B、3、4S期< 12月龄患者的4年总生存率为98.5%，显著高于4期< 12月龄患者的73.1%（P < 0.0001）。当患者年龄≥ 12个月时，1、2A、2B和3期神经母细胞瘤患者的4年总生存率为100%，而4期患者的4年总生存率为48.5%（P < 0.0001）。按国际神经母细胞瘤病理分类组织学，< 12个月组中组织学良好的患者4年总生存率为98.8%，组织学不良的患者为60.7%（P < 0.0001）。在≥ 12个月组中，组织学良好者的4年口腔生存率为95.3%，组织学不良者为50.6%（P < 0.0001）。在生物学因素中，MYCN扩增、DNA二倍体和1 p缺失与< 12月龄患者的不良预后显著相关，MYCN扩增和DNA二倍体在≥ 12月龄患者中也是如此。多变量分析显示，INSS分期（4期与其他分期）和国际神经母细胞瘤病理学分类组织学（不利与有利）与接受治疗的患者的生存率显著且独立相关，按年龄、分期和MYCN扩增分层（分别为P=0.0002和P=0.0051）。© 2002英国癌症研究中心。
The International Neuroblastoma Staging System and Pathology Classification were proposed in 1988 and in 1999, respectively, but their clinical value has not yet been fully studied in new patients. Six hundred and forty-four patients with neuroblastoma treated between January 1995 and December 1999 were analysed by these classifications. The 4-year overall survival rate of patients < 12 months of age with INSS stages 1, 2A, 2B, 3 and 4S disease was 98.5%, which was significantly higher than the 73.1% rate in stage 4 patients < 12 months (P < 0.0001). When patients were greater than or equal to 12 months, the 4-year overall survival rate of patients with neuroblastoma at 1, 2A, 2B and 3 stages was 100% and that of patients at stage 4 was 48.5% (P < 0.0001). As to the International Neuroblastoma Pathology Classification histology, the 4-year overall survival rate was 98.8% in patients with favourable histology and 60.7% in those with unfavourable histology in the < 12 months group (P < 0.0001). In the greater than or equal to 12 months group, the 4-year oral survival of patients with favourable histology was 95.3% and that of patients with unfavourable histology was 50.6% (P < 0.0001). Among biological factors, MYCN amplification, DNA diploidy and 1p deletions were significantly associated with poor prognosis in patients < 12 months, as were MYCN amplification and DNA diploidy in patients ≥ 12 months of age. Multivariate analysis showed that the INSS stage (stage 4 vs other stages) and International Neuroblastoma Pathology Classification histology (unfavourable vs favourable) were significantly and independently associated with the survival of patients undergoing treatment, stratified by age, stage and MYCN amplification (P=0.0002 and P=0.0051, respectively). © 2002 Cancer Research UK.