尿中甲基胺预测高风险神经母细胞瘤完全缓解期间的复发
Yvette A H Matser1, Atia Samim1,2, Marta Fiocco1,3,4
1Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
JCO precision oncology
|February 21, 2025
概括
尿中的甲醇胺可以帮助评估神经母细胞瘤治疗反应. 完全缓解后的高水平表明复发和死亡的风险更高,有助于高风险神经母细胞瘤患者的风险分层.
科学领域:
- 儿科瘤学 儿科瘤学
- 生物标志物发现发现
- 癌症治疗方法 癌症治疗方法
背景情况:
- 尿中的类甲醇胺是确定的神经母细胞瘤诊断标记物.
- 它们在监测治疗反应和预测结果方面的作用尚不清楚.
- 目前的应对标准不包括catecholamine水平.
研究的目的:
- 在高风险神经母细胞瘤中检查尿中甲醇胺的反应监测.
- 评估它们对生存结果的预测价值.
- 评估与完全缓解 (CR) 相关的甲基荷兰胺.
主要方法:
- 从2005年到2021年,在153名高风险神经母细胞瘤患者中测量了8种尿中甲基胺.
- 诊断时 (Dx),治疗期间和CR时评估的甲基胆胺水平.
- 使用修订的国际神经母细胞瘤应答标准,与无事件生存率 (EFS) 和总生存率 (OS) 相关联的甲基荷兰胺状况.
主要成果:
- 在Dx时检测到97%的,在诱导后81%的和在CR时57%的儿科胺含量升高.
- 主要瘤切除显著降低了甲基荷胺水平 (P < .01).
- 在CR的阳性catecholamine状态与EFS (38%对80%,P < .01) 和OS (52%对86%,P = .01) 的差异相关.
- 在CR中增加的3-甲西胺预测了糟糕的OS (HR,7.5).
结论:
- 尿中甲基胺测量有助于评估高风险神经母细胞瘤中的CR.
- 在CR中阳性catecholamine状态识别了患有复发和死亡风险增加的患者.
- 甲基胆胺水平提供了超出当前反应标准的预后价值.
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