The role of GD2 as a diagnostic and prognostic tumor marker in neuroblastoma (literature review)

Abstract

Neuroblastoma (NB) is a rare malignant tumor characterized by highly variable biological behavior, including spontaneous and induced regression, maturation, and progression. To assess the prognosis and response to therapy in NB, the determination of a number of oncological markers is used, such as neuron-specific enolase, lactate dehydrogenase, ferritin. Nevertheless, the models for assessing the prognosis developed so far do not fully predict the specificity of the course of the disease. In this regard, the creation of methods for monitoring tumor status in real time, based on the analysis of circulating tumor biomarkers, seems to be extremely urgent. A characteristic feature of NB is the expression of various gangliosides on the surface of tumor cells. In particular, the content of disialoganglioside GD2 reaches up to 30 % of all gangliosides. At the same time, the level of GD2 expression depends on the differentiation of neurogenic tumors: the highest concentrations are determined on NB cells, the lowest – on ganglioneuroblastoma and ganglioneuroma. The phenomenon of “shedding”, the so-called flushing, of GD2 from the NB cell membrane made it possible to estimate its concentration in the peripheral bloodstream. The article discusses the evolutionary path of the methodology for detecting GD2 in blood serum, with an emphasis on the recently introduced liquid chromatography/ tandem mass spectrometry technique, which can be used as a starting point for the emergence of GD2 as a soluble biomarker of the tumor process, which is undoubtedly a powerful application in the clinical practice that offers hope for improved diagnosis, prognosis and riskadapted therapy strategies based on well-defined, measurable determinants in accordance with the concept of evidence-based medicine.