Clinical Significance of Tyrosine Hydroxylase mRNA Transcripts in Peripheral Blood at Diagnosis in Patients with Neuroblastoma.

PURPOSE

The purpose of this study is to investigate the clinical significance of tyrosine hydroxylase (TH) expression in peripheral blood (PB) at diagnosis in patients with neuroblastoma.

MATERIALS AND METHODS

mRNA expression in PB was measured by reverse transcription quantitative real-time polymerase chain reaction in 210 patients who were newly diagnosed with neuroblastoma from July 2005 to June 2015 and the clinical significance of expression in PB at diagnosis was evaluated.

RESULTS

expression was positive in 60 patients (28.6%). Fifty of 60 -positive patients had metastatic tumors and the remaining 10 had localized tumors. expression was associated with high-risk features (i.e., advanced stage, older age, unfavorable pathology, and amplification) at diagnosis. Among -positive patients, higher expression level was observed in high-risk patients than in low- or intermediate-risk patients (p=0.035). The probability of 5-year progression-free survival (PFS) was lower in -positive patients than in -negative patients (63.8±6.9% vs. 94.7±2.1%, p < 0.001). In analysis confined to high-risk patients, the 5-year probability of PFS remained lower in -positive patients (55.7±8.2% vs. 89.6±5.8%, p < 0.001). Among -positive patients, a higher expression level of was associated with a worse outcome. In multivariate analyses, positive expression in PB at diagnosis was an independent poor prognostic factor for PFS.

CONCLUSION

The treatment intensity should be tailored according to expression in PB at diagnosis.