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Original article
The prognostic roles of and correlation between ALK and MYCN protein expression in neuroblastoma
  1. Hsiu-Hao Chang1,
  2. Meng-Yao Lu1,
  3. Yung-Li Yang1,2,
  4. Shu-Wei Chou1,
  5. Dong-Tsamn Lin1,2,
  6. Kai-Hsin Lin1,
  7. Wen-Ming Hsu3,
  8. Yung-Ming Jeng4,5,
  9. Shiann-Tarng Jou1
  1. 1Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
  2. 2Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
  3. 3Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
  4. 4Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
  5. 5Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan
  1. Correspondence to Dr Yung-Ming Jeng; mrna0912{at}gmail.com; Dr Shiann-Tarng Jou; Stjou4{at}gmail.com

Abstract

Aims To investigate the relations between anaplastic lymphoma kinase (ALK) and v-myc myelocytomatosis viral related oncogene neuroblastoma derived homolog (MYCN) protein expression and their prognostic roles in neuroblastoma tumours.

Methods Sixty-one neuroblastoma tumours obtained at diagnosis were stained with anti-MYCN and anti-ALK antibodies by immunohistochemical staining. The correlations between protein expression of MYCN, ALK and clinicopathological and biological variables of neuroblastoma tumours were analysed.

Results High expression of ALK protein could be detected in 25 (41%) and high expression of MYCN protein could be detected in 24 (39.3%) of the 61 neuroblastoma tumours, respectively. The majority of neuroblastoma tumours with evident of ALK or MYCN protein high expression exhibited undifferentiated or poorly differentiated histology (30/35, 85.7%). ALK or MYCN protein high expression in neuroblastoma tumours was associated with adverse clinical prognostic factors and ALK protein high expression was significantly associated with MYCN protein high expression. In addition, either ALK or MYCN protein high expression in neuroblastoma tumours was the independent adverse prognostic factor and also predicted worse survival outcomes for neuroblastoma patients with MYCN non-amplified status or non-high-risk Children’s Oncology Group grouping.

Conclusions Our study showed a novel coordinately prognostic role of ALK and MYCN protein expression in neuroblastoma and is the first report to demonstrate the correlation between ALK and MYCN protein expression in primary neuroblastoma tumours.

  • ALK
  • MYCN
  • neuroblastoma
  • protein expression

https://doi.org/10.1136/jclinpath-2019-206063

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    Footnotes

    • Handling editor Dhirendra Govender.

    • Contributors H-HC, Y-MJ and S-TJ designed the study, collected the data, analysed the data, and drafted and edited the manuscript. M-YL, Y-LY, S-WC, D-TL, K-HL and W-MH collected the data, and reviewed and edited the manuscript.

    • Funding This work was supported by grants from the National Taiwan University Hospital (NTUH 107-S3777 and 108-S4194 to H-HC) and Ministry of Science and Technology, Taiwan (MOST 104-2314-B-002-168-MY3 and 108-2314-B-002-154 to H-HC).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This manuscript has been read and approved by all authors, has not been published and is not under consideration for publication elsewhere. The study has been approved by the institutional research ethics board of the National Taiwan University Hospital.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.