Abstract
Neuroblastoma (NB), is a neuroectodermal tumor derived from neural crest cells, and it is the second most common pediatric malignant tumor. The biological and clinical behavior of NB is very heterogeneous. This study was conducted to evaluate the expression of Ki-67, p53 and VEGF markers in tissues obtained from NB patients with different histologic types and stage. Tissue microarray (TMA) blocks were constructed from paraffin blocks of the NB tissues. Immunohistochemical staining was performed on TMA sections to detect the expression of Ki-67, p53 and VEGF markers. The association between the expression of these markers and clinicopathological parameters were then analyzed. We had 18 patients with NB, one patient with ganglioneuroblastoma (GNB) and one with ganglioneuroma. Ki-67 was expressed in 13 (65%) tumors, and negatively correlated with age, prognosis, histologic type and stage of NB (all p<0.05). High and moderate expression of VEGF was found in 5% (1/20) and 65% (13/20) of the tumors, respectively; and it was positively correlated with age, prognosis and histologic types (all p<0.05) and negatively correlated with MKI (mitosis-karyorrhexis index). p53 expression was observed in 10% (2/20) of the tumors, which showed a relative correlation with MKI (p value=0.07). VEGF as a candidate for anti-angiogenic targeted therapy was correlated with the development and progression of NB; therefore, VEGF along with Ki-67 can serve as a valuable marker for the prognosis of this tumor type.
Highlights
Neuroblastoma (NB) is the second most common pediatric malignant tumor and the most common solid tumor of childhood consisting of neural crest-derived tumors with cellular heterogeneity and different clinical behaviors (Tong et al, 2008; Owens and Irwin, 2012; Pistoia et al, 2013; Zhang et al, 2013)
High and moderate expression of vascular endothelial growth factor (VEGF) was found in 5% (1/20) and 65% (13/20) of the tumors, respectively; and it was positively correlated with age, prognosis and histologic types and negatively correlated with MKI. p53 expression was observed in 10% (2/20) of the tumors, which showed a relative correlation with MKI (p value=0.07)
Increased tumor angiogenesis occurs in high-risk NB tumors which is supported by vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), transforming growth factor alpha (TGF-alpha) and platelet-derived growth factor A (PDGF-A) (Modak and Cheung, 2010)
Summary
Neuroblastoma (NB) is the second most common pediatric malignant tumor and the most common solid tumor of childhood consisting of neural crest-derived tumors with cellular heterogeneity and different clinical behaviors (Tong et al, 2008; Owens and Irwin, 2012; Pistoia et al, 2013; Zhang et al, 2013). High and moderate expression of VEGF was found in 5% (1/20) and 65% (13/20) of the tumors, respectively; and it was positively correlated with age, prognosis and histologic types (all p
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