title: Serum-Based Quantification of MYCN Gene Amplification in Young Patients with Neuroblastoma: Potential Utility as a Surrogate Biomarker for Neuroblastoma.
abstract: We previously developed a method for determining MYCN gene amplification status using cell-free DNA fragments released from cancer cells into the blood of patients with neuroblastoma (NB). Here, we analyzed the relationship between MYCN amplification (MNA) status and neuroblastoma prognosis. We screened serum samples from 151 patients with NB for MNA, using real-time quantitative PCR, and compared the results with MYCN status determined using paired tumor samples. We additionally investigated whether MNA status correlates with patient survival. When a cut-off value of 5 was used, serum-based MNA analysis was found to show good sensitivity (86%) and very high specificity (95%). The sensitivities for stage 1 and 2 might be acceptable, even though it is not as good as for stage 3 and 4 (67% for stage 1 and 2, 92% for stage 3, and 87% for stage 4). MNA status correlated with overall survival in our cohort of 82 patients, with survival data available (p < 0.01). The hazard ratio of MNA status was 4.98 in patients diagnosed at less than 18 months of age (95% confidence interval, 1.00-24.78), and 1.41 (95% confidence interval, 0.63-3.14) for those diagnosed at 18 months of age or older. Serum-based MNA analysis is rapid and non-invasive compared with tumor-based MNA analysis, and has potential to predict tumor MNA status. There is still a room to improve the sensitivity of the test for tumors of stages 1 and 2, nonetheless this assay might help to determine therapeutic strategies prior to tumor biopsy, especially for patients with a life-threatening condition, as well as for patients of less than 18 months of age whose risk-grouping and treatment allocation depends on their MNA status.
authors: Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Shigeki
authors: S
authors: Yagyu
authors: Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Tomoko
authors: T
authors: Iehara
authors: Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
authors: Shiro
authors: S
authors: Tanaka
authors: Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Takahiro
authors: T
authors: Gotoh
authors: Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Akiko
authors: A
authors: Misawa-Furihata
authors: Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Tohru
authors: T
authors: Sugimoto
authors: Division of Hematology/Oncology, Children's Hospital Boston/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, United States of America.
authors: Wendy B
authors: WB
authors: London
authors: Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors: Michael D
authors: MD
authors: Hogarty
authors: Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Satoshi
authors: S
authors: Teramukai
authors: Division of Biochemistry and Innovative Cancer Therapeutics, Chiba Cancer Center, Chiba, Japan.|Saga Medical Cancer KOSEIKAN, Saga, Japan.
authors: Akira
authors: A
authors: Nakagawara
authors: Department of Pediatric Surgery, Hiroshima University Hospital, Natural Science Center for Basic Research and Development, Hiroshima University, Hiroshima, Japan.
authors: Eiso
authors: E
authors: Hiyama
authors: Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors: John M
authors: JM
authors: Maris
authors: Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Hajime
authors: H
authors: Hosoi
mesh_terms: D015415:Biomarkers / Q000097:blood*; D005260:Female; D005784:Gene Amplification; D006801:Humans; D007223:Infant; D008297:Male; D000071447:N-Myc Proto-Oncogene Protein / Q000097:blood / Q000235:genetics*; D009447:Neuroblastoma / Q000097:blood / Q000175:diagnosis* / Q000235:genetics*; D011379:Prognosis; D060888:Real-Time Polymerase Chain Reaction; D015996:Survival Rate
chemical_list: D015415:Biomarkers; C459801:MYCN protein, human; D000071447:N-Myc Proto-Oncogene Protein