The Expression Of Nm23,PCNA,Neu In The Neuroblastoma

Neuroblastoma is predominantly a tumor of childhood, over 90% of patients are less than ten years of age. It is one of the most common malignant neoplasms of the first decade and often shows the most unpredictable clinical behaviors with a tendency of spontaneous maturation or regression. So it is important to find out the development and differentiation of patients. But the classical histological classification such as Shimada, M.Hughe sand Evans, can not give a precision prognosis and classification of this tumor. So we want to detect the exprssion of nm23 , PCNA, and Neu in neuroblastoma. We want to find out the relationship between these molecular markers and the prognosis.Material and method:All tumor samples came from five hospitals of our province. There are 43 cases from 1993-2001. All the tumors were classified according to the system proposed by Shimada.In this system the tumor was divided as favorable histology(FH) and unfavorable histology(UH) All pieces were embedded in paraffin, and serially selected for morphology and immunohistochemistry (SP) analysis. The chi-square test and Kaplan-Meier were used for the statistics. (p<0.05 was considered significant).Results:(1). Of the patients under five years old, 14 cases(70%) have FH classification. But the patients whose ages are above five years, only 6 cases(30%) have the FHclassification. There is a significant relativity between the age and Shimada classification (P<0.05). The earlier we detect the tumor, the more Favorable histology grades can we find. (2).The expression of nm23 increases form the FH classification (45.0%) to the UHclassification (56.5%). But there is not a significant difference between them(P>0.05). (3).The expression of PCNA increases greatly from the FH classification(20.0%) to the UH classification's. 9%). There is a significant difference between them(P<0.01). (4). The expression of Neu increases from the FH classification(25.0%) to the UH classification (65.2%). There is a significant difference between them(P<0.05). (5). It has significant correlation with the expression of PCNA and Neu.(p<0.05). (6). The expression of PCNA has a great influence on the survival time(.P<0.05,Long Rank,Breslow,Tarone-Ware tests).Conclusion:From this experiment it could be said: (1).The earlier we detect the tumor, the more FH grades can we find. So we can improve the prognosis of this tumor by the early diagnosis, although it was a little difficult. (2). nm23 can not be a precisim director in neuroblastoma. (3).Neu and PCNA can be an important director in the pathologic grade. The high expression of Neu and PCNA in the neuroblastoma always shows an unfavorable prognosis. (4).The expression of neu and PCNA has a relativity in the neuroblastoma, so when we use Neu and PCNA together, a more exact prognosis we can find. (5).Because the positive expression of PCNA has a great influence on the survival time of neuroblastoma and the detection of PCNA is much more convenient and precision, PCNA can be a very important molecular maker in the diagnoses and therapy of neuroblastoma.