Cystathionine as a Potential Urinary Marker for Diagnosing and Assessing Pretreatment Risk in Neuroblastoma

Area of Science:

• Pediatric Oncology
• Biomarker Discovery
• Urine Metabolomics

Background:

• Neuroblastoma diagnosis and risk assessment currently rely on invasive methods.
• Established urinary markers like HVA and VMA have limitations in risk stratification.
• Novel, non-invasive biomarkers are needed for improved patient management.

Purpose of the Study:

• To investigate cystathionine (CTN) as a potential urinary biomarker for neuroblastoma.
• To evaluate CTN's utility in diagnosing neuroblastoma.
• To assess CTN's performance in pretreatment risk stratification using INRG and COG classifications.

Main Methods:

• Urine samples from 80 participants (controls, primary neuroblastoma, residual tumors) were analyzed.
• Liquid chromatography/mass spectrometry was used to quantify urinary CTN, HVA, and VMA.
• Receiver operating characteristic curve analysis (ROC-AUC) evaluated diagnostic and risk assessment performance.

Main Results:

• CTN demonstrated superior diagnostic performance (AUC=0.946) compared to HVA (AUC=0.920) and VMA (AUC=0.903).
• CTN showed significant utility in pretreatment risk assessment (AUCs ranging from 0.708 to 0.981) across INRG and COG classifications.
• CTN also showed high accuracy (AUC=0.942) in predicting MYCN status.

Conclusions:

• Urinary cystathionine (CTN) is a promising biomarker for neuroblastoma diagnosis.
• CTN exhibits significant potential for non-invasive pretreatment risk assessment in neuroblastoma patients.
• Further validation of CTN could lead to improved, less invasive neuroblastoma management strategies.