Analysis of the initial symptoms and its diagnostic significance in children with neuroblastoma

Abstract

Objective To explore the significance of the initial clinical symptoms and clinical manifestations of neuroblastoma(NB) to achive early identification of NB. Methods A retrospective study was performed on patients diagnosed with NB, who attended the Hematology Oncology Center, Beijing Children′s Hospital from March 31st, 2007 to March 31st, 2015.The clinical characteristics were compared between the children <1-year-old and ≥ 1-year-old.The result was analyzed to compare the difference in clinical symptoms and tumor biologic characteristics of patients with different initial clinical symptoms between 2 groups. Results A total of 330 patients were included in the study, 43 of them were younger than 1 year old, and their most common symptoms were cough and fever(each 17 cases, and accounted for 39.5%, respectively); while the most common symptoms in patients ≥1-year-old (287 cases) was fever(177 cases, 61.7%), followed by lymphadenopathy(107 cases, 37.3%), bone pain(97 cases, 33.8%) and anemia(48 cases, 16.7%). The frequency of symptoms differed significantly between 2 groups(all P<0.05), such as fever(39.5% vs.61.7%, χ2=6.68), anemia(4.7% vs.16.7%, χ2=6.00), bone pain(0 vs.33.8%, χ2=18.99), abdo-minal pain(0 vs.25.3%, χ2=10.19), diarrhea(16.3% vs.3.0%, χ2=12.73), lymphadenopathy(7.0% vs.37.3%, χ2=14.12) and anorexia(9.3% vs.33.4%, χ2=9.21). Patients had fever, anemia, lymphadenopathy, cutaneous hemorrhagic spot or periorbital ecchymosis, bone pain, abdominal pain, exophthalmos, and anorexia early in the initial course of the disease, whose serum lactate dehydrogenase values were significantly increased(P<0.05). Patients suffered from fever, anemia, lymphadenopathy, bone pain, limbs dysfunctions, abdominal pain at the beginning of the disease, whose urine vanillymandelic acid values were higher than normal(P<0.05). Conclusions The study of symptomology suggests the most common symptoms in patients with NB <1-year-old are cough and fever, while those ≥1-year-old are fever, lymphadenopathy, bone pain, and anemia.For patients with symptoms mentioned, carrying out the necessary NB-diagnose-related laboratory and imaging studies was statistically relevant to patients′ ages(<1-year-old and ≥1-year-old), which may contribute to earlier identification and diagnosis of NB. Key words: Neuroblastoma; Symptomatology; Identifying