MYCN Fish combined with immunohistochemistry is a more prognostic factor for neuroblastoma

Background: MYCN is an identified driver and important prognosticator of neuroblastoma and performs biological function at protein level. At present, most detection methodologies focus on MYCN DNA level and fail to detect MYCN protein expression for poor antibody, especially in China.Results：In the present study, through the analysis of neuroblastoma gene expression profile data, we found MYCN expression is closely related with prognosis of neuroblastoma, especially in stage I-III and IVs at RNA level in current medical conditions. FISH was almost accurate as WES to test MYCN DNA level based on our hospital data. In 56 neuroblastoma cases, IHC analysis by a newfound antibody (#84406s, Cell Signaling Technology) demonstrated a 75%-85% concordance with FISH. Further analyzing those cases with inconsistent results, we found patients with FISH+ but IHC score<9 all had no adverse events, while 63.6% patients with FISH+ and IHC score≥9 tended to have poor outcome. As to those MYCN FISH- patients, once their tumor showed MYCN protein expression, all of them were poor prognosis, while 81% of the rest patients with neither MYCN gene nor protein expression had ideal prognosis.Conclusions: The results suggest that this newfound antibody is reliable in IHC, and IHC combined with FISH performs better in evaluating prognosis and guiding treatment.