Miale T D, Kirpekar K
Department of Pediatrics, University of Tennessee Medical Center, Knoxville 37950-0642, USA.
Med Oncol. 1994;11(3-4):89-100. doi: 10.1007/BF02999856.
A review of stage IV-S neuroblastoma is provided. The possible uses of prognostic features to guide treatment options in this group of infants with neuroblastoma are suggested. The biologic basis for the spontaneous regression of widespread tumor involvement in some infants with stage IV-S neuroblastoma is discussed. The reasons that some infants with IV-S disease progress to a fatal outcome, while most undergo maturation or involution and eventual long term cure are suggested. The influence of such factors as age at diagnosis, clinical staging, and tumor biology on eventual outcome are covered. Biological variables and markers discussed include: genetic (cytogenetics (1p deletions), nuclear genomic content), molecular biologic (N-myc oncogene amplification, mdr-1, ras, and trk, gene expression), immunological (major histocompatibility antigen density, cellular and humoral immunity), and biochemical (creatine kinase isoenzyme profile, neuron specific enolase, ferritin, chromatograffin, lactic acid dehydrogenase and catecholamine levels).
本文对IV-S期神经母细胞瘤进行了综述。提出了预后特征在指导这组神经母细胞瘤婴儿治疗方案中的可能用途。讨论了部分IV-S期神经母细胞瘤婴儿广泛肿瘤受累自发消退的生物学基础。提出了一些IV-S期疾病婴儿进展至致命结局，而大多数经历成熟或消退并最终长期治愈的原因。涵盖了诊断时年龄、临床分期和肿瘤生物学等因素对最终结局的影响。讨论的生物学变量和标志物包括：遗传学（细胞遗传学（1p缺失）、核基因组含量）、分子生物学（N-myc癌基因扩增、mdr-1、ras和trk、基因表达）、免疫学（主要组织相容性抗原密度、细胞和体液免疫）以及生物化学（肌酸激酶同工酶谱、神经元特异性烯醇化酶、铁蛋白、嗜铬粒蛋白、乳酸脱氢酶和儿茶酚胺水平）。
