Limitations in the ability of NB84 to detect metastatic neuroblastoma cells in bone marrow.
BACKGROUND
The accurate assessment of metastases is an essential component of the staging process for children with neuroblastoma.


OBJECTIVE
To study the sensitivity of the immunohistochemical marker neuroblastoma 84 (NB84) for the detection of bone marrow infiltrates in children with stage 4 neuroblastoma.


METHODS
Primary tumour specimens, bone marrow trephine biopsy specimens and lymph node metastases, taken from children with neuroblastoma that had metastasised to bone marrow, were assessed with a panel of commonly used immunohistochemical markers for neuroblastoma. A comparison was drawn between the sensitivity of the marker NB84 for primary tumours and for bone marrow metastases.


RESULTS
NB84 immunolabelled all pre-chemotherapy and post-chemotherapy (n = 24) paired primary tumour specimens, as well as each of a further 20, unpaired, pre-chemotherapy primary tumour specimens. It also labelled all (n = 4) lymph node metastases. Immunolabelling of bone marrow trephine biopsy specimens (21/33) was less sensitive. Of 16 primary tumour specimens with a paired bone marrow trephine biopsy specimen, all immunostained positive, whereas only 62.5% of bone marrow biopsy specimens immunostained positive for NB84. The number of bone marrow biopsy specimens immunostaining for NB84 was significantly lower than the number of paired primary tumour specimens (p = 0.041).


CONCLUSIONS
NB84 remains a useful marker for the diagnosis of neuroblastoma in primary tumour specimens, but not for neuroblastoma that has metastasised to bone marrow.
Department of Paediatric Oncology, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
S N
SN
Bomken
K
K
Redfern
K M
KM
Wood
M M
MM
Reid
D A
DA
Tweddle
D000911:Antibodies, Monoclonal / Q000276:immunology; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000276:immunology; D001706:Biopsy; D001856:Bone Marrow Examination / Q000379:methods; D019046:Bone Marrow Neoplasms / Q000175:diagnosis* / Q000556:secondary; D002648:Child; D006801:Humans; D007124:Immunoenzyme Techniques; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000175:diagnosis* / Q000188:drug therapy / Q000556:secondary; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor