Clinical relevance of CD44 cell-surface expression and N-myc gene amplification in a multicentric analysis of 121 pediatric neuroblastomas

被引:82
作者
Combaret, V
Gross, N
Lasset, C
Frappaz, D
Peruisseau, G
Philip, T
Beck, D
Favrot, MC
机构
[1] CTR LEON BERARD, CELL BIOL LAB, F-69373 LYON 08, FRANCE
[2] CTR LEON BERARD, DEPT PEDIAT, F-69373 LYON 08, FRANCE
[3] UNIV LAUSANNE HOSP, DEPT PEDIAT, ONCOHEMATOL UNIT, LAUSANNE, SWITZERLAND
关键词
D O I
10.1200/JCO.1996.14.1.25
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: In contrast to other human tumors, a repression of the cell-surface glycoprotein CD44 on neuroblastoma is a marker of aggressiveness that usually correlates to N-myc amplification. We thus compared the prognostic value of both markers in the initial staging of 121 children treated for neuroblastoma in collaborative institutions. Methods: Frozen samples were analyzed by a rapid and well-standardised technique of immunostaining with monoclonal antibodies (MoAbs) against epitopes in the CD44 constant region. Results: In this retrospective series, CD44 was expressed 102 specimens and strongly correlated with favorable tumor stages and histology, younger age, and normal N-myc copy numbers. In univariate analysis, CD44 expression and normal N-myc were the most powerful markers of favorable clinical outcome (P < 10(-6) and chi(2) = 65.40; and P < 10(-6) and chi(2) = 42.56, respectively), but analysis of CD44 affords significant prognostic discrimination in subgroups of patients with or without N-myc-amplified tumors. In the subgroup of stage IV neuroblastomas, CD44 was the only significant prognostic marker (P < .02, chi(2) = 5.76), whereas N-myc status was not discriminant. In multivariate analysis of five factors, ie, N-myc amplification, CD44 expression, age, tumor stage, and histology, the only independent prognostic factors of event-free survival were CD44 expression and tumor stage. Conclusion: The analysis of CD44 cell-surface expression must be recommended as an additional biologic marker in the initial staging of the disease.
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页码:25 / 34
页数:10
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