Wang Zuopeng, Wang Chengyun, Xu Yibing, Le Jun, Jiang Yuan, Yao Wei, Wang Hongsheng, Li Kai
Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, China.
Department of Pediatric Surgery, Zaozhuang Maternal and Child Health Care Hospital, Shandong, China.
Front Oncol. 2021 May 14;11:633106. doi: 10.3389/fonc.2021.633106. eCollection 2021.
The NB5 assay was performed in bone marrow (BM) and peripheral blood (PB) to detect neuroblastomas (NBs) with micrometastases. The sensitivity and factors influencing the NB5 assay were preliminarily evaluated.
The NB5 assay uses RT-PCR to detect the co-expression of five mRNAs from the neuroblastoma-associated genes, CHGA, DCX, DDC, PHOX2B, and TH. We enrolled 180 cases of neuroblastoma and 65 cases of non-neuroblastoma. Bone marrow and peripheral blood were collected from every patient. The gold standard for the diagnosis of NB was pathological evaluation of solid tumor specimens or bone marrow biopsies (BMBs) from hematological tumors. STATA version 15 and SPSS version 17 software were used for analysis.
We found that 17 patients were BMB (+), and they were diagnosed as the International Neuroblastoma Staging System (INSS) stage IV and the high-risk group. All 17 patients were BM (+), while 15 patients were PB (+) (15/17, 88.2%). Among the 163 children who were BMB (-), 56 were BM (+), 40 were PB (+), and 36 were BM (+) and PB (+). The sensitivity of the NB5 assay in BM (40.5%) and PB (30.5%) was significantly higher than the sensitivity of BMB (9.4%, P = 0.000). In the non-NB group, four cases were BM (+) and one case was PB (+). The specificity of the NB5 assay in BM and PB was 93.8% and 98.5%, respectively. The sensitivity of the NB5 assay in both BM and PB in INSS stage IV patients was significantly higher than that in INSS stage I-II patients (P <0.05). The sensitivity of the NB5 assay in both BM and PB in the high-risk group was significantly higher than that in the middle-low-risk groups (P = 0.0001). Logistic regression analyses indicated that liver metastases and bone metastases were the primary factors influencing the sensitivity of the NB5 assay in BM and PB (P <0.05).
The NB5 assay had significantly higher sensitivity than the pathological analysis of BMB in detecting NB with micrometastases. The NB5 assay had higher sensitivity in INSS stage IV or the high-risk group. Liver metastases and bone metastases were the primary factors that affected the sensitivity of the NB5 assay.
采用NB5检测法检测骨髓（BM）和外周血（PB）中的微小转移神经母细胞瘤（NBs），并初步评估NB5检测法的敏感性及影响因素。
NB5检测法利用逆转录聚合酶链反应（RT-PCR）检测神经母细胞瘤相关基因CHGA、DCX、DDC、PHOX2B和TH的五种mRNA的共表达情况。我们纳入了180例神经母细胞瘤患者和65例非神经母细胞瘤患者，采集了每位患者的骨髓和外周血。NB诊断的金标准是实体瘤标本的病理评估或血液系统肿瘤的骨髓活检（BMBs）。使用STATA 15版和SPSS 17版软件进行分析。
我们发现17例患者BMB（+），这些患者被诊断为国际神经母细胞瘤分期系统（INSS）IV期且为高危组。所有17例患者BM（+），而15例患者PB（+）（15/17，88.2%）。在163例BMB（-）的儿童中，56例BM（+），40例PB（+），36例BM（+）且PB（+）。NB5检测法在BM（40.5%）和PB（30.5%）中的敏感性显著高于BMB的敏感性（9.4%，P = 0.000）。在非NB组中，4例BM（+），1例PB（+）。NB5检测法在BM和PB中的特异性分别为93.8%和98.5%。NB5检测法在INSS IV期患者的BM和PB中的敏感性均显著高于INSS I-II期患者（P <0.05）。NB5检测法在高危组的BM和PB中的敏感性均显著高于中低危组（P = 0.0001）。逻辑回归分析表明，肝转移和骨转移是影响NB5检测法在BM和PB中敏感性的主要因素（P <0.05）。
在检测微小转移NB方面，NB5检测法的敏感性显著高于BMB的病理分析。NB5检测法在INSS IV期或高危组中具有更高的敏感性。肝转移和骨转移是影响NB5检测法敏感性的主要因素。
