NIMG-17. CLINICOPATHOLOGIC AND ULTRASOUND VARIABLES ASSOCIATED WITH THE UNFAVORABLE PATHOLOGY IN NEUROBLASTOMA

Abstract

Abstract BACKGROUND The International Neuroblastoma Pathology Classification has a prognostic impact that distinguishes two neuroblastoma categories: favorable histology (FH) and unfavorable histology (UFH). The aim of this study was to identify the clinicopathological and ultrasound variables that were associated with the UFH. METHODS With ethic approval, the clinical, pathologic, and ultrasonographic data of the 104 patients with the pathologic diagnosis of neuroblastoma were retrospectively analyzed. Pathologic findings were ascertained by the paraffin pathologic, fluorescent in situ hybridization (FISH), and the immunohistochemical stain analysis. Tumors were assessed for the following ultrasonographic characteristics: size, boundary, shape, internal echo, acoustic pattern, posterior features, calcification, internal blood flow, and pushing peripheral organs. Univariate and multivariate logistic regression analyses were used to assess the clinicopathologic and ultrasound variables that were associated with UFH. RESULTS There were 27 neuroblastoma cases (26.0%) of the UFH group. The independent clinicopathologic variables for the UFH were: older than one year (Odds ratio [OR]=32.84, p=0.003), presence of metastases (OR=4.92, p=0.032), and the MYCN amplification ratio >5 (OR=47.06, p=0.003). The independent ultrasound feature of neuroblastoma which associated with UFH was the ill-defined boundary (OR=4.64, p=0.047) and tumor size ≥50mm (OR=15.77, p=0.05). CONCLUSION Patients older than one year, with the presence of metastases, and the MYCN amplification ratio >5 on the FISH analysis as well as the ill-defined boundary and tumor size ≥50mm on an ultrasound assessment were associated with the UFH in neuroblastoma. These characteristics of the neuroblastoma should be considered in patient stratification and prognostic evaluation. Key words: Neuroblastoma; Unfavorable histology; Ultrasound