Oppedal B R, Storm-Mathisen I, Lie S O, Brandtzaeg P
Laboratory for Immunohistochemistry and Immunopathology (LIIPAT), University of Oslo, National Hospital, Norway.
Cancer. 1988 Aug 15;62(4):772-80. doi: 10.1002/1097-0142(19880815)62:4<772::aid-cncr2820620422>3.0.co;2-u.
Tumor samples from 58 patients diagnosed and treated for neuroblastoma or ganglioneuroblastoma in a single institution from 1967 to 1981 were included in a study of prognostic factors. Histopathology, certain immunohistochemical markers, and DNA ploidy were evaluated along with clinical variables such as tumor stage, primary site, and patient's age at diagnosis. Children under 1.5 years of age at diagnosis had a much better prognosis than did older ones, and this variable was the best prognostic indicator. Tumor Stages I to II and IVS, primary tumor site above the diaphragm, and tumor differentiation were also related to a better prognosis. The Shimada classification was of no additional prognostic value in our study. Neither was the immunohistochemical marker pattern, but it was sometimes helpful in establishing the tumor diagnosis. Tumor-cell ploidy, however, seemed to afford additional prognostic information because the 11 patients with aneuploid tumors under the age of 1.5 years at diagnosis all survived in contrast to only five of nine patients with diploid tumors in the same age group. It is possible that this was due to a better response to treatment in the aneuploid group. Our results suggest that patients with diploid neuroblastomas of undifferentiated histology and those over the age of 1.5 years at diagnosis might be selected for more intense treatment.
1967年至1981年期间，在某单一机构诊断并接受治疗的58例神经母细胞瘤或神经节神经母细胞瘤患者的肿瘤样本被纳入一项预后因素研究。对组织病理学、某些免疫组化标志物以及DNA倍性进行了评估，并结合了临床变量，如肿瘤分期、原发部位以及诊断时患者的年龄。诊断时年龄在1.5岁以下的儿童预后比年龄较大的儿童好得多，这一变量是最佳的预后指标。肿瘤I至II期和IVS期、原发肿瘤位于膈肌上方以及肿瘤分化程度也与较好的预后相关。在我们的研究中，岛田分类法没有额外的预后价值。免疫组化标志物模式也没有，但它有时有助于确立肿瘤诊断。然而，肿瘤细胞倍性似乎能提供额外的预后信息，因为诊断时年龄在1.5岁以下的11例非整倍体肿瘤患者全部存活，而同一年龄组的9例二倍体肿瘤患者中只有5例存活。这可能是由于非整倍体组对治疗的反应更好。我们的结果表明，对于诊断时组织学未分化的二倍体神经母细胞瘤患者以及年龄在1.5岁以上的患者，可能需要选择更强化的治疗。
