神经母细胞瘤眼部转移与N-myc癌基因扩增的临床意义

Ocular metastasis of neuroblastoma and amplification of N myc oncogene

目的通过定量研究小儿神经母细胞瘤（ＮＢ）Ｎ－ｍｙｃ基因扩增倍数，观察ＮＢ眼部转移以及与预后的关系。方法选择２５例Ⅳ期ＮＢ患儿（有眼部转移１５例、无眼部转移１０例）做骨穿，有眼部转移者并取转移灶组织，用内参照差示聚合酶链反应（ＰＣＲ）的方法确定ＮＢ细胞的Ｎ－ｍｙｃ拷贝数。结果２５例中有２４例（９６％）出现Ｎ－ｍｙｃ扩增，眼部转移组平均拷贝数（５１．３±３２．４）显著高于无眼部转移组的平均拷贝数（４．３±２．８），Ｐ＜０．０５，且前者两年生存率明显低于后者。结论ＮＢ的疗效及预后与癌基因扩增倍数密切相关，扩增倍数高者预后差。应用差示ＰＣＲ方法可及时判断预后，且操作简便快速，适于临床推广应用。

Objective To study the effects of amplification of N myc oncogene on the oculometastasis and prognosis of neuroblastoma (NB).Methods The authors detected the bone marrow and metastasized tumor in 25 cases of NB in stage Ⅳ with differential polymerase chain reaction, among whom 15 had oculometastasis.Results Amplification of N myc oncogene was found in 24 of 25 cases (96.0%). The N myc copy number in oculometastasis group (51.3±32.4) was higher than that in non oculometastasis group (4.3±2.8) ( P <0.05), and the 2 year survival rate of the former was significantly lower than that of the latter ( P <0.05).Conclusion N myc oncogene has effects on the prognosis of NB. Meanwhile, the differential PCR and local puncture are techniques suitable to be developed in clinical practice.