RESUMO
BACKGROUND AND PURPOSE: The serum alpha-fetoprotein (AFP) level has been used as a tumor marker for hepatoblastoma, and malignant germ cell tumors in pediatric patients. The AFP has 3 isoforms (L1, L2, L3), and the usefulness of the L3 fraction as a diagnostic marker for the adult hepatocellular carcinoma is well known. However, there are few reports dealing with various pediatric malignant tumors. In the current study, we analyzed the diagnostic value of AFP fractions for pediatric diseases, in particular, those occurring in the neoinfantile period. MATERIALS AND METHODS: From 2003 to 2006, two cases of hepatoblastoma, and 5 cases of germ cell tumor, all of which were neoinfantile, were treated in our department. In our analytical system (LiBASys), the level of the L3 fraction contains the majority of the L2 fraction. The total AFP (ng/mL) level and the L3 fraction (%) were measured to assess the usefulness of the L3 fraction as a diagnostic marker. RESULTS: In all cases of hepatoblastoma and yolk sac tumor, both the total AFP and the L3 fraction were high, either before treatment or in the presence of malignant tumors. Most of the cases of neonatal immature teratoma showed a high total AFP level during the neoinfantile period, however, the L3 fraction was around 10%, and decreased after surgical treatment. Only 1 case of the immature teratoma demonstrated malignant transformation, when the patient was 8 months old. As the total AFP and the AFP-L3 fraction were proportionally elevated, the patient was treated with additional surgical resection and chemotherapy. In the case of neonatal mature teratoma, the L3 fraction was below 0.5%, even when the total AFP level was high. DISCUSSION: Our results indicated that the level of the L3 fraction accurately confirmed the existence, or the malignant potential of hepatic tumor or germ cell tumor. The L3 fraction is useful as a tumor marker during the neoinfantile period.
Assuntos
Biomarcadores Tumorais/sangue , Hepatoblastoma/sangue , Neoplasias Hepáticas/sangue , Neoplasias Embrionárias de Células Germinativas/sangue , alfa-Fetoproteínas/análise , Feminino , Hepatoblastoma/diagnóstico , Humanos , Lactente , Recém-Nascido , Lectinas , Neoplasias Hepáticas/diagnóstico , Masculino , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Isoformas de Proteínas/sangueRESUMO
PURPOSE: To select the optimal treatment according to the grade of malignancy of neuroblastoma (NB), it is essential to accurately and rapidly identify genetic abnormalities associated with the prognosis. We have identified BIN1 and neuronatin beta as the novel prognosis-related genes for NBs. This study aims to assess the correlation between the combination of the expression level of prognosis-related genes and the outcome of NB. METHODS: In 44 NB samples, the expression levels of TrkA, BIN1, and neuronatin beta were determined using quantitative reverse transcriptase-polymerase chain reaction; furthermore, the correlation between the expression of these genes' expression levels and the clinical progression of NB were assessed. RESULTS: It was possible to classify 44 NBs into 4 groups regarding the grade of malignancy of NB. These 4 groups were all significantly associated with the clinical stages international NB staging system as well as the outcomes of the patients (P < .001, according to the trend test by Kruskal-Wallis exact test). CONCLUSION: The combination of the expression levels of these genes using quantitative reverse transcriptase-polymerase chain reaction is indicated as the effective method to quickly and accurately evaluate the grade of malignancy of NBs.
Assuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Regulação Neoplásica da Expressão Gênica , Neuroblastoma/classificação , Neuroblastoma/genética , Proteínas Nucleares/genética , Proteínas Oncogênicas/genética , Receptor trkA/genética , Proteínas Supressoras de Tumor/genética , Southern Blotting , Criança , Pré-Escolar , Feminino , Predisposição Genética para Doença , Humanos , Lactente , Recém-Nascido , Masculino , Proteína Proto-Oncogênica N-Myc , Neuroblastoma/patologia , Probabilidade , Prognóstico , RNA Neoplásico/análise , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Estudos de Amostragem , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Técnicas de Cultura de TecidosRESUMO
We herein present a case of a neonatal cervical cyst, which was diagnosed prenatally, and markedly decreased in size and disappeared after a local injection therapy of OK-432. A 0-day-old boy had an abnormal prenatal ultrasonography scan suggestive of rt. cervical cyst, measuring about 25 mm in diameter at 29 weeks' gestation. At birth, an elastic soft mass, measuring about 30 mm in diameter, was found on the right side of his neck. Computed tomography (CT) scans showed a giant cyst, which extended from the upper level of epipharynx to the upper mediastinum, and the contents were air and fluid. At 20 days of age, ultrasonography (US)-guided needle aspiration was performed. The aspirated fluid contained no epithelial cells, but many lymphocytes and neutrophils based on a cytological analysis. After the local injection of OK-432 had been performed four times, the right neck cyst had almost completely disappeared on US scans. During the local injection therapy, we analyzed the other sample of the second aspiration fluid of the neck cyst. Several clusters of epithelial cells, columnar epithelium, squamous cells, and ciliated epithelium were thus cytologically observed. Therefore, a final diagnosis of a branchial cleft cyst was made. The local injection of OK-432 was thus found to be an effective treatment for branchial cleft cysts.
