title: Tumor cell dynamics and metastasis in advanced neuroblastoma.
abstract: This study deals with the advancement process of neuroblastoma through clinical observations and circulating tumor cell exploration. Clinical feature, tumor biology, and circulating tumor cell detected by the previously described polymerase chain reaction (PCR) method were analyzed in 31 patients with advanced neuroblastoma treated in our department since 1991 through 2004. Treatment was completed in 28 patients, of whom 17 are alive without the disease and 11 died. The primary lesion was not confirmed in 2 patients with disseminated metastasis, both of whom showed positive circulating tumor cell. Circulating tumor cell was positive in 6 of 9 examined at their first appearance at the hospital, all had stage 4 disease, and 4 of the 6 (66.7%) died of systemic spread of the disease. N-myc was amplified in 15 patients, of whom only 2 (13.3%) died of systemic metastasis. N-myc amplification did not correlate with positive circulating tumor cell. A certain population of neuroblastoma may provide circulating tumor cells from the early period of the disease to form metastatic lesions independently of the primary lesion, which must be regulated by factors other than N-myc. Circulating tumor cells may suggest higher risk for systemic dissemination and poor prognosis.
authors.affiliation: Department of Surgery, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan. kuroda-t@ncchd.go.jp
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kuroda
authors.forename: Toshiro
authors.initials: T
authors.lastname: Honna
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Morikawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kitano
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fuchimoto
authors.forename: Kan
authors.initials: K
authors.lastname: Terawaki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kumagai
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Tsunematsu
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Masaki
authors.forename: Kentaro
authors.initials: K
authors.lastname: Matsuoka
authors.forename: Morihiro
authors.initials: M
authors.lastname: Saeki
mesh_terms: D001859:Bone Neoplasms / Q000097:blood / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D016259:Genes, myc; D006801:Humans; D007223:Infant; D009362:Neoplasm Metastasis; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D009447:Neuroblastoma / Q000097:blood / Q000473:pathology*