COMPARISON OF DNA ANEUPLOIDY, CHROMOSOME-1 ABNORMALITIES, MYCN AMPLIFICATION AND CD44 EXPRESSION AS PROGNOSTIC FACTORS IN NEUROBLASTOMA

A comparison of the prognostic impact of five molecular variables in a large series was made, including tests of their nonrandom association and multivariate analysis. Molecular data were available for 377 pati ents and MYCN amplification, cytogenetic chromosome Ip deletion, loss of chromosome Ip heterozygosity, DNA ploidy and CD44 expression were i nvestigated. Their interdependence and influence on event-free surviva l was tested uni- and multivariately using Pearson's chi(2)-test, Kapl an-Meier estimates, log rank tests and the Cox's regression model. MYC N amplification was present in 18% (58/322) of cases and predicted poo rer prognosis in localised (P < 0.001), metastatic (P = 0.002) and eve n 4S (P = 0.040) disease. CD44 expression Was found in 86% (127/148) o f cases, and was a marker for favourable outcome in patients with neur oblastoma stages 1-3 (P = 0.003) and 4 (P = 0.017). Chromosome Ip dele tion was cytogenetically detected in 51% (28/55), and indicated reduce d event-free survival in localised neuroblastoma (P = 0.020). DNA ploi dy and loss of heterozygosity on chromosome Ip were of less prognostic value. Most factors of prognostic significance were associated with e ach other. By multivariate analysis, MYCN was selected as the only rel evant factor. Risk estimation of high discriminating power is, therefo re, possible for patients with localised and metastatic neuroblastoma using stage and MYCN.