Criteri Istologici per La Valutazione Prognostica Del Neuroblastoma

Histologic and immunohistochemical investigation of neuroblastomas and correlation with prognosis

Forty-one confirmed cases of childhood neuroblastoma diagnosed over a 13-year period were reviewed and reclassified. Most of the tumors were stained using a peroxidase antiperoxidase method for neuron specific enolase (NSE), protein gene product (PGP) 9.5, and S100 protein, all of which have previously been reported to be positive in some neuroblastomas. The relation to prognosis of the histology and immunohistochemistry was studied. There was a significant trend toward improved survival with increasing degree of differentiation, and with decreasing mitosiskaryorrhexis index (MKI) in the stroma-poor group. There was no significant correlation between immunohistochemical staining and survival, although the presence and amount of staining for all three markers tended to increase with tumor differentiation. This study concludes that histologic classification in neuroblastoma is helpful in assessing prognosis but that the clinical features are generally more reliable as indicators of prognosis. The immunohistochemistry of markers used did not contribute towards assessment of prognosis.

Neuronal and glial markers in tumours of neuroblastic origin

The presence and distribution of different neural markers in 30 neuroblastic tumours (neuroblastomas, ganglioneuroblastomas) and 6 non-neuroblastic tumours were investigated by immunocytochemistry. Neuron-specific enolase (NSE), S-100 protein, tyrosine hydroxylase, neurofilaments and glial fibrillary acidic protein (GFAP) were localised in 3 undifferentiated neuroblastic tumours (group A), 12 poorly differentiated tumours (group B) and 15 well differentiated neuroblastic tumours (group C). Non-neuroblastic tumours (3 lymphomas and 3 Ewing sarcomas) showed no immunoreactivity. Tyrosine hydroxylase and, in particular, NSE were found in mature ganglion cells and developing neuroblasts of poorly and well differentiated tumours (groups B and C). S-100 was localised in neuroblasts with slender cytoplasmic processes in the same groups. Neurofilaments were detected in ganglion cells and differentiated neuroblasts (groups B and C) while GFAP was localised in immature neuroblasts of undifferentiated and poorly differentiated tumours (groups A and B). Thus, there are differences in the neural proteins found in neuroblastic tumours and a wide panel of antibodies against neural markers may be a useful tool in the histological assessment of nervous system neoplasms.