Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2020 Apr 13;35(14):e82. doi: 10.3346/jkms.2020.35.e82.
This study aimed to investigate the incidence and clinical significance of segmental chromosomal aberrations (SCAs) in Korean patients with neuroblastoma.
Patients diagnosed with neuroblastoma from 2012 to 2018 were included for retrospective review. Fluorescence in situ hybridization (FISH) was used to analyze four SCAs ( amplification, 1p deletion, 11q deletion, and 17q gain). Clinical characteristics at diagnosis, early tumor response (reduction in primary tumor volume and neuron-specific enolase level after the first three cycles of chemotherapy), and survival rates were compared according to SCAs.
Among 173 patients with FISH results, 92 (53.2%) had at least one of the four SCAs, while 25 (14.5%) had two co-aberrations, and eight (4.6%) had three co-aberrations. SCAs detected in our study were amplification (n = 17, 9.8%), 1p deletion (n = 26, 15.2%), 11q deletion (n = 44, 25.6%), and 17q gain (n = 46, 27.1%). Patients with amplification showed a better early response but a worse survival than those without (5-year overall survival: 46.2% ± 13.1% vs. 88.6% ± 3.4%). Furthermore, 1p deletion was associated with a better early response but a worse survival; however, it was not an independent factor for survival. We could not find any prognostic significance associated with 11q deletion or 17q gain.
This is the first study investigating SCAs in Korean neuroblastoma patients. Prognostic significance of SCAs other than amplification was different from those reported in western countries. Further study with a larger cohort and longer follow-up is needed to confirm our findings.
本研究旨在探讨韩国神经母细胞瘤患者中节段性染色体异常(SCA)的发生率和临床意义。
回顾性纳入 2012 年至 2018 年诊断为神经母细胞瘤的患者。采用荧光原位杂交(FISH)分析四种 SCA(扩增、1p 缺失、11q 缺失和 17q 增益)。根据 SCA 比较诊断时的临床特征、早期肿瘤反应(化疗前三个周期后原发肿瘤体积和神经元特异性烯醇化酶水平的降低)和生存率。
在有 FISH 结果的 173 例患者中,92 例(53.2%)至少有一种四种 SCA 之一,25 例(14.5%)有两种共异常,8 例(4.6%)有三种共异常。本研究中检测到的 SCA 为扩增(n = 17,9.8%)、1p 缺失(n = 26,15.2%)、11q 缺失(n = 44,25.6%)和 17q 增益(n = 46,27.1%)。扩增的患者早期反应较好,但生存较差,无扩增患者的 5 年总生存率为 88.6% ± 3.4%)。此外,1p 缺失与更好的早期反应相关,但生存较差;然而,它不是生存的独立因素。我们没有发现 11q 缺失或 17q 增益与预后相关的任何意义。
这是第一项研究韩国神经母细胞瘤患者 SCA 的研究。除扩增外,SCA 的预后意义与西方国家报道的不同。需要进一步进行更大队列和更长随访的研究来证实我们的发现。