The Effect Of ATRX Protein Expression And Correlational Clinical Indicators For Prognosis Of Neuroblastoma

Part 1 The Effect of ATRX Protein Expression forPrognosis of NeuroblastomaBackgroud and ObjectiveNeuroblastoma(NB or NBL)is a disease that changes in a great range of the clinical manifestation and prognosis differences,from tumor infiltration,spread,transfer to death,or tumor differentiation and mature like benign ganglioneuroma cells or spontaneous regression as clinical outcomes.ATRX gene was found in 1981,ATRX protein in 2014 was selected as one of the central nervous system(CNS)tumor markers.From molecular level to explore the tumorigenesis,tumor progression and outcome of neuroblastoma,which has become the consensus of neuroblastoma research currently.Whereas,this experiment will detect ATRX protein expression in the tumor tissue,to discuss their effects on the prognosis of children with NB.MethodsSelect patients who were treated by the first affiliated hospital of Zhengzhou University,pediatric surgery from 2016-01-01 to 2019-08-31 with neuroblastoma as the research object.The deadline for the 2020-02-29.Children with neuroblastoma(NB)32 cases,ganglioneuroblastoma(GNB)10 cases,ganglioneuroma(GN)10 cases(as control)were designed,making tissue microarray and slice,HE staining and immunohistochemical(IHC),through the Image J software IHC Tool Box statistics all specimens at high power field ATRX protein in the cell nucleus number of dyeing per unit area,combined with long-term follow-up survival situation.Use Kaplan-Meier statistic method to observe ATRX protein expression and the Log-Rank test to know the impact on the prognosis of children with NB.Results1.Comparing with the difference of ATRX protein expression level in NB,GNB and GN was statistically significant.ATRX protein in NB was lower expression than in GNB and GN.2.ATRX protein expression level has no statistically significant difference in NB+GNB and GN groups.3.The differences of ATRX protein expression level in different risk stratification has no statistical significance,and was no associated with risk stratification.4.The differences of ATRX protein expression have no statistically significant effect on the prognosis of children with NB.5.A correlation between ATRX protein expression and the time of NB confirmed diagnosis is existed,and which with MYCN gene amplification is not existed.ConclusionsATRX protein expression is associated with the diagnosis time of children with NB,and the deficient expression of ATRX protein indicates the poor prognosis of NB.Part 2 The Correlational Analysis of Different Clinical Indicators for Prognosis of NeuroblastomaBackground and ObjectiveNeuroblastoma(NB or NBL)is derived from the neural crest embryonal tumour,is one of the most common extracranial substantive tumors in children,its most remarkable characteristic is wide diversified clinical biological behaviors.Currently International Neuroblastoma Staging System namely INSS and International Neuroblastoma Risk Group Staging System namely INRGSS that is a preoperative staging system are usually used by clinical doctors,and risk classifications are on the basis of their staging system respectively,analysis of different stages and classification on the prognosis of children with NB evaluation effect,clear the clinical value of different factors on the prognosis of NB evaluation,and further explore the independent factors affecting the prognosis of possible effects on the prognosis of patients with NB.MethodsRetrospectively analyzed clinical datum of cases and pathological report of 32 cases,which the first part mentioned,combined with long-term follow-up survival situation,by using Kaplan-Meier statistic method to calculate survival rate and median survival time,and the Log-Rank test to know the impact of different clinical indicators on the prognosis of children with NB.Apply Cox Regression and try to fit proportional hazard model to study different factors for the effect on prognosis of children with NB.Results1.The follow-up to the survival of children with 32 cases,lost to follow-up 9 cases(28.1%),8 cases died(25%),15 cases(46.9%).The average survival time was(27.58±2.23)months,median overall survival time was 27.60 months,the overall survival rate was 75%.2.To analyze the NB children in ages,preoperative chemotherapy or not,NSE,pathological immunohistochemical results of the expression of synaptic(Syn),neural adhesion molecule(CD56,NACM),CD99 and Ki67 or not and MYCN gene amplification or not and Shimanda pathological classification effect on the prognosis of children with NB,with Kaplan-Meier and Log-Rank test statistics analysis and comparison of the above factors of different influence on the prognosis of children with NB,except ages but other factors difference was not significant statistically.But reduce the level of data for statistical analysis,PCD56=0.036<0.05,there is statistical significance,in another words,CD56 expression or not,the prognosis of children with NB may be different.3.Compared the difference of INSS,INRGSS,INSS risk grading,INRGSS risk classification influence on the prognosis of children with NB,when ? takes 0.05,INSS,INRGSS,INSS risk grading and INRGSS risk classification have no statistical significance for the prognosis of children with NB;When ? take 0.1,INRGSS to evaluate prognosis of children with NB have statistical significance.4.Compared INSS IV and INRGSS M for the difference in prognosis of NB children assessment,there was no statistically significant difference(Log-rank ?2-=0.805,P=0.370,?=0.05).5.Compared INSS and INRGSS assessment for children with high-risk group of NB cumulative survival probability,there was no statistically significant difference(Log-rank)?2=0.133,P=0.715).6.Comparative analysis for INSS risk classification and INRGSS risk classification evaluative difference for prognosis of the high-risk group of NB children by the Log-rank test,P>0.05,have no statistical significance.7.By Cox single factor survival analysis to screen variables,build a proportional hazards model,when the INSS risk grading and INRGSS risk classification were using as stratification variables respectively,MYCN gene amplification on the prognosis of children with NB through Cox stratification regression analysis,in this study case PINSS=0.131,PINRG=0.291,?=0.05,has no statistical significance,but by the bootstrap key in SPSS proceeding the analysis of large sample stratified sampling,PINSS=PINRG=0.055,?=0.1 there is statistical significance,in other words,in general or large sample size of the crowd,INSS risk grading and INRGSS risk classification have an effect on which at the time of MYCN gene amplification condition assessing its impact on the prognosis of children with NB.8.MYCN gene amplification is dangerous survival factor for children with NB,according to ? CD56<0,RR<1,we speculated that CD56 may be a protective factor for the prognosis of children with NB.Conclusions1.CD56 may be a dangerous factor for the prognosis of children with NB.2.The accuracy of INRGSS assessment for the prognosis of children with NB is different.