PEDIATRICS Vol. 88 No. 5 November 1991, pp. 1018
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CURRENT URINARY MASS SCREENING FOR CATECHOLAMINE METABOLITES AT 6 MONTHS OF AGE MAY BE DETECTING ONLY A SMALL PORTION OF HIGH-RISK NEUROBLASTOMAS: A CHROMOSOME AND N-myc AMPLIFICATION STUDY

J. F. L. MD

We studied 96 infants and children with untreated neuroblastomas. Chromosomes of tumor cells were analyzed in 68, and N-myc copy numbers were determined in 67 patients. Patients found by a mass screening program for 6-month-old infants (group A1, 39 patients) or those less than 12 months of age found clinically (group A2, 13 patients) were rarely in the disseminated stage . . .

. . . Most tumors found by the screening showed known characteristics predicting a good prognosis, and the majority of tumors showing characteristics predicting a poor prognosis were found in patients aged between 12 and 36 months. Our chromosome and N-myc amplification studies suggest that a low-risk tumor does not usually evolve to a high-risk tumor. Thus the current mass screening program may be detecting only a small portion of highly malignant neuroblastomas at the earliest stage. Infants should be screened twice, at 6 months as well as at 12 months of age, for the early detection of high-risk neuroblastomas.