SIGNIFICANCE OF NEUROPEPTIDE Y IN EARLY DIAGNOSIS AND AS A PROGNOSTIC FACTOR OF NEUROBLASTOMA

检测44例神经母细胞瘤(NB)患者和48例非NB患者的血浆神经肽Y(NPY)浓度。NPY诊断NB的敏感性和特异性分别为84%和92%。NB1岁以下病例NPY显著低于1岁以上病例，神经节细胞瘤NPY显著低于神经母细胞瘤，组织学良好(FH)明显低于组织学不良(UH)，大规模筛查发现的NPY显著低于大规模筛查阴性病例，早期病例低于晚期病例。NPY与尿VMA、HVA、血浆NSE、LDH、铁蛋白等肿瘤标志物均无相关性。按血浆NPY浓度(第1组：1000pg/ml，第2组：1000~3000pg/ml，第3组：3000pg/ml)分析NPY与预后的关系。组1的存活率明显好于组2和组3。组1的患者全部存活，无任何疾病迹象。第1组FH预后良好，第2、3组预后不佳。将4例N-myc扩增的患者分为2组和3组，分别检测尿液NPY和浓度为40~200pg/ml的NPY样免疫反应。发现尿液中NPY的主要成分向低分子重量区转移。NPY被认为是在泌尿系统中代谢的，可以测量尿液中NPY的浓度。

Plasma neuropeptide Y(NPY) concentrations were detected in 44 cases with neuroblastoma (NB) and 48 cases without NB.Sensitivity and specificity of NPY on the diagnosis of NB were 84% and 92%, respectively. NPYs in NB cases were significantly lower in cases of younger than 1-year-old than in older cases, in granglioneuroma than in neuroblastoma, in favorable histology (FH) than in unfavorable histology (UH), in cases detected by mass screening than in mass screening negative cases, in early staged cases than in advanced cases, respectively. NPYs did not correlated with any other tumor markers including VMA and HVA in urine, plasma NSE, LDH and ferritin. NB cases were divided by the plasma NPY concentrations (Group 1 : < 1,000 pg/ml, Group 2 : 1,000-3,000 pg/ml, Group 3 : > 3,000 pg/ml) to analyze the relationship between NPYs and prognosis. Survival rate of Group 1 was significantly better than those of Group 2 and 3. All of the patients of Group 1 survived without any evidence of disease. The prognosis of FH cases in Group 1 was excellent but the prognoses of FH in Group 2 and 3 were not good. Four patients with amplified N-myc were classified in Group 2 or 3.Urinary NPY was measured and NPY like immunoreactivity from 40 to 200 pg/ml in concentration was detected. It was found that major component of NPY in urine shifted to low molecular wieght area. It was considered NPY to be metabolized at the urinary system and to be possible to measure urinary NPY concentrations.