阶段(地层学)
N-Myc公司
医学
基因复制
癌基因
肿瘤进展
神经母细胞瘤
内科学
总体生存率
无进展生存期
基因
胃肠病学
病理
癌症研究
生物
癌症
遗传学
神经节细胞瘤
古生物学
细胞周期
细胞培养
作者
Robert C. Seeger,Garrett M. Brodeur,Harland N. Sather,A. Condon Dalton,Stuart E. Siegel,Kwan Y. Wong,Denman Hammond
标识
DOI:10.1056/nejm198510313131802
摘要
Eighty-nine patients with untreated primary neuroblastomas were studied to determine the relation between the number of copies of the N-myc oncogene and survival without disease progression. Genomic amplification (3 to 300 copies) of N-myc was detected in 2 of 16 tumors in Stage II, 13 of 20 in Stage III, and 19 of 40 in Stage IV; in contrast, 8 Stage I and 5 Stage IV-S tumors all had 1 copy of the gene (P less than 0.01). Analysis of progression-free survival in all patients revealed that amplification of N-myc was associated with the worst prognosis (P less than 0.0001); the estimated progression-free survival at 18 months was 70 per cent, 30 per cent, and 5 per cent for patients whose tumors had 1, 3 to 10, or more than 10 N-myc copies, respectively. Of 16 Stage II tumors, 2 with amplification metastasized, whereas only 1 of 14 without amplification did so (P = 0.03). Stage IV tumors with amplification progressed most rapidly: nine months after diagnosis the estimated progression-free survival was 61 per cent, 47 per cent, and 0 per cent in patients whose tumors had 1, 3 to 10, or more than 10 copies, respectively (P less than 0.0001). These results suggest that genomic amplification of N-myc may have a key role in determining the aggressiveness of neuroblastomas.
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