Neuroblastoma: new approaches to diagnosis

Monoclonal antibodies can play an important part in distinguishing neuroblastoma from other small round cell tumours of childhood. In addition, they have been useful in the identification of metastatic tumour cells in bone marrow. Though these roles for antibodies are now well proven, other functions for these reagents such as radioimmunolocalization and targeted therapy need further evaluation. The problems in the diagnostic use of monoclonal antibodies are reviewed and an assessment given on the type of panels that can be constructed as diagnostic aids. Other new diagnostic approaches in vivo and in vitro are reviewed for comparison. The rapidly developing specialties of molecular biology and molecular cytogenetics will almost certainly have an impact on the diagnosis and prognosis of patients with neuroblastoma. Although these are currently research tools, in a short time they will be in use in routine diagnosis. With the increased basic research into neuroblastoma, it is hoped that it will not be too long before the overall survival rate for the disease is improved. In the meantime the new diagnostic approaches outlined in this paper will ensure that patients are treated with an appropriate chemotherapeutic regimen and will allow the selection of subgroups of individuals for new aggressive chemo/radiotherapeutic protocols.