All are good prognostic factors in Neuroblastoma except
**Question:** All are good prognostic factors in Neuroblastoma except
A. MYCN gene amplification
B. Age at diagnosis
C. Serum neuron-specific enolase (NSE) level
D. Serum lactate dehydrogenase (LDH) level
**Core Concept:** Neuroblastoma is a malignant tumor originating from neural crest cells, most commonly found in children. The prognosis in neuroblastoma depends on several factors, including MYCN gene amplification, age at diagnosis, serum neuron-specific enolase (NSE) level, and serum lactate dehydrogenase (LDH) level.
**Why the Correct Answer is Right:**
Correct Answer: D. Serum lactate dehydrogenase (LDH) level
LDH is a marker enzyme present in all cells and is released into the bloodstream when cells are damaged or dying. In neuroblastoma, an elevated LDH level may indicate widespread disease or tumor burden, which is associated with a poorer prognosis. Thus, an elevated LDH level is considered a poor prognostic factor.
**Why Each Wrong Option is Incorrect:**
A. MYCN gene amplification: This is a poor prognostic factor as it is a chromosomal abnormality that occurs in approximately 20-25% of neuroblastomas and is associated with a high-risk disease and poor outcomes.
B. Age at diagnosis: Children younger than 1 year old have a better prognosis due to their immature immune system and tumor biology.
C. Serum neuron-specific enolase (NSE) level: High serum NSE levels are associated with a poor prognosis in patients with neuroblastoma.
**Why the Correct Answer is Right:**
Correct Answer: D. Serum lactate dehydrogenase (LDH) level
LDH is a marker enzyme present in all cells and is released into the bloodstream when cells are damaged or dying. In neuroblastoma, an elevated LDH level may indicate widespread disease or tumor burden, which is associated with a poorer prognosis. Thus, an elevated LDH level is considered a poor prognostic factor.
**Why Each Wrong Option is Incorrect:**
A. MYCN gene amplification: This is a poor prognostic factor as it is a chromosomal abnormality that occurs in approximately 20-25% of neuroblastomas and is associated with a high-risk disease and poor outcomes.
B. Age at diagnosis: Children younger than 1 year old have a better prognosis due to their immature immune system and tumor biology.
C. Serum neuron-specific enolase (NSE) level: High serum NSE levels are associated with a poor prognosis in patients with neuroblastoma.