Abstract:Objective: To analyze the combined levels of serum Neuron-Specific Enolase (NSE),urinary Vanillylmandelic Acid (VMA),and blood cell parameters for evaluating the prognosis of children with neuroblastoma. Methods: 101 children with neuroblastoma treated at our hospital from January 2018 to March 2021 were divided into a survival group and a death group based on the 2-year follow-up outcomes,consisting of 69 cases in the survival group and 32 cases in the death group.General clinical data,laboratory index levels,platelet and red blood cell parameters were compared between the two groups.Additionally,the laboratory index levels were compared among children with different clinical stages. Results: The comparison of general clinical data between the two groups revealed no significant differences in age,gender,primary tumor site,pathological type,and mean platelet volume (P>0.05).In the survival group,there was a lower proportion of children in stages Ⅲ~Ⅳ,N-myc gene positivity,high-risk category,bone marrow metastasis,NSE,serum ferritin (SF),lactate dehydrogenase (LDH),C-reactive protein (CRP),24-hour urinary VMA levels,platelet distribution width,and red blood cell distribution width compared to the death group,with statistically significant differences (P<0.05).Children in stages Ⅰ~Ⅱ had significantly lower levels of NSE,SF,LDH,CRP,and 24-hour urinary VMA compared to children in stages Ⅲ~Ⅳ,with statistically significant differences (P<0.05).Platelet crit was higher in the survival group than in the death group with statistical significance (P<0.05).Logistic regression analysis indicated that the stage,NSE,24-hour urinary VMA,and platelet distribution width were influencing factors for the prognosis of children with neuroblastoma (P<0.05).NSE (ng/mL),platelet distribution width (%),and 24-hour urinary VMA measurements had AUC values for predicting the prognosis of children with neuroblastoma,which were 0.862 (0.791~0.932),0.838 (0.743~0.934),and 0.748 (0.641~0.856),respectively.The corresponding cutoff values were 45.565,10.375,and 51.405,with sensitivities of 0.823,0.781,and 0.711,specificities of 0.841,0.790,and 0.681,and Youden indices of 0.664,0.571,and 0.392,respectively. Conclusion: VMA,NSE,and platelet distribution width are associated with the prognosis of children with neuroblastoma.The combination of these parameters has good clinical value in predicting the prognosis of children with neuroblastoma.
沈夏赢, 金鑫, 李树锦. 血清NSE尿VMA水平联合血细胞分析评估神经母细胞瘤患儿预后的价值分析[J]. 河北医学, 2023, 29(11): 1826-1832.
SHEN Xiaying, JIN Xin, LI Shujin. Value Analysis of Serum NSE and Urinary VMA Levels Combined with Blood Cell Analysis to Evaluate the Prognosis of Children with Neuroblastoma. HeBei Med, 2023, 29(11): 1826-1832.
[1] Bhardwaj N,Rohilla M,Trehan A,et al.MYCN amplification and international neuroblastoma risk group stratification on fine-needle aspiration biopsy and their correlation to survival in neuroblastoma[J].Journal of Clinical Pathology,2022,54(2):1033-6. [2] Weng T F,Wu K H.Haploidentical peripheral blood stem cell transplantation with posttransplant cyclophosphamide in a child with neuroblastoma relapse after autologous peripheral blood stem cell transplantation[J].Pediatric Blood & Cancer,2022,69(2):29439. [3] Furlanetto G,Spagnol F,Alegretti A P,et al.Flow cytometry as a diagnostic tool in neuroblastoma[J].Journal of Immunological Methods,2021,498(3):113135. [4] Altini C,Villani M F,Giannatale A D,et al.Tandem high-dose 131I-MIBG therapy supported by dosimetry in pediatric patients with relapsed-refractory high-risk neuroblastoma:the bambino gesu' children's hospital experience[J].Nuclear Medicine Communications,2022,43(2):129-144. [5] Li J,Liu X,Chen M,et al.Values of serum CA125,NSE and 24-hour urine VMA in diagnosis and prediction of treatment of paediatric neuroblastoma[J].International Journal of Clinical Practice,2021,75(12):14932. [6] Zhang D,Kaweme N,Duan P,et al.Upfront treatment of pediatric high-risk neuroblastoma with chemotherapy,surgery and radiotherapy combination:the CCCG-NB-2014 protocol[J].Frontiers in oncology,2021,11(8):745794. [7] 中国抗癌协会小儿肿瘤专业委员会,中华医学会小儿外科学分会肿瘤外科学组.儿童神经母细胞瘤诊疗专家共识[J].中华小儿外科杂志,2015,36(1):3-7. [8] 靳燕,袁晓军,赵强,等.神经母细胞瘤CCCG-NB-2015共识多中心应用总结[J].中国肿瘤临床,2023,50(9):433-442. [9] 战世佳,张璇,张瑶,等.溶质载体家族7成员11对MYCN基因扩增高危神经母细胞瘤细胞增殖的影响[J].中国药理学与毒理学杂志,2023,37(8):565-573. [10] 简冰林,苏雁,秦红,等.53例单纯手术治疗极低危组、低危组神经母细胞瘤患儿临床特征及近期预后分析[J].中国小儿血液与肿瘤杂志,2021,26(4):238-242. [11] 张梅慧,姜大朋.先天性神经母细胞瘤发病机制与临床特点的研究进展[J].临床小儿外科杂志 2022,21(2):141-145. [12] 闫杰,杨嘉兴,靳燕,等.儿童神经母细胞瘤预后模型的构建[J].中华转移性肿瘤杂志,2021,4(4):266-273. [13] 张林楠,刘玉峰,苏淑芳,等.血小板分布宽度对神经母细胞瘤预后的预测价值[J].中华实用儿科临床杂志,2020,35 (6):440-444. [14] 马越.472例儿童神经母细胞瘤的临床特征及预后的单中心回顾性分析[D].重庆:重庆医科大学,2021.