Pancreastatin immunoreactivity in favourable childhood neuroblastoma and ganglioneuroma.

Neuroblastoma and its benign counterpart, ganglioneuroma, are tumours of the sympathetic nervous system, and known to produce and release various regulatory peptides. In this study, pancreastatin, a 52 amino acid regulatory peptide derived from chromogranin A, was analysed in plasma and tumour tissue from 15 children with neuroblastoma and one with ganglioneuroma. Detectable pancreastatin immunoreactivity (> 1.9 pmol/l) was found in plasma in 13 of 15 children with highest concentrations in samples from children with favourable outcome (P < 0.05). In tumour tissue, non-metastatic tumours showed higher concentrations of pancreastatin immunoreactivity (P < 0.05). However, the highest concentrations were detected in tumours from children with favourable prognosis, regardless of clinical stage at presentation (P < 0.01). Serial plasma samples from one child with neuroblastoma and one with ganglioneuroma were investigated and showed significant systemic release of pancreastatin immunoreactivity during surgical manipulation of tumours with high pancreastatin concentrations. It is concluded that pancreastatin immunoreactivity may be detected in plasma samples and tumour extracts from children with neuroblastoma and ganglioneuroma. Systemic release during surgery implied tumour origin of elevated plasma pancreastatin. Furthermore, higher pancreastatin concentrations correlate with tumour differentiation, localised clinical stage and a favourable outcome for children with these tumours. It is suggested that pancreastatin in plasma and tumour tissue may be utilised as a marker indicating favourable tumour behaviour.