What tests are needed for neuroblastoma in children?

Children's neuroblastoma (Neuroblastoma) is a common childhood cancer, and its diagnosis usually requires a combination of clinical symptoms, imaging tests, laboratory tests, pathological tests and other methods. The following are common inspection methods:

1. Physical examination and medical history

Initial diagnosis usually begins with a detailed history and physical examination. The doctor will ask parents for detailed information about the child's symptoms (such as abdominal mass, pain, fever, etc.) and conduct a physical examination to evaluate whether there are masses, swollen lymph nodes, or other abnormal signs.

2. Imaging examination

Imaging examination is a key method for the diagnosis of neuroblastoma, which is used to determine the location, size, metastasis and extent of tumor invasion into adjacent tissues.

Ultrasound: Often the preferred initial examination, especially for the evaluation of abdominal masses. Ultrasound can tell whether the tumor is in the adrenal glands or the abdominal cavity.

X-ray (X-ray): Often used to check for metastases to the lungs or bones, especially if the tumor is suspected to have spread to the bones.

Computed tomography (CT):CT scan is a commonly used imaging examination method that can clearly show the shape, size, location of the tumor and whether there is metastasis to lymph nodes or other organs. CT is of great value in detecting the local extension of tumors and their location.

Magnetic Resonance Imaging (MRI):MRIis often used to evaluate in detail the presence of tumors in the spinal cord, pelvis, or chest. For the evaluation of the central nervous system, MRI is particularly important because it can show whether the tumor is compressing or invading the spinal cord and brain.

Positron emission tomography (PET): PETScans can show metabolic activity in tumors throughout the body and are particularly useful for detecting metastatic lesions or lesions that cannot be seen with other imaging tests.

3. Laboratory examination

Laboratory tests can help support the diagnosis of neuroblastoma and evaluate the biology of the tumor.

Urine testing: Neuroblastoma is often associated with high levels of metabolites (such as vanillomandelic acid and catecholamines), which can be detected through urine testing. Especially in high-risk cases, urine testing can help confirm the diagnosis and predict the progression of the disease.

Blood tests: Blood tests are often used to evaluate a tumor's secretory activity, liver function, kidney function, and anemia. In some patients, tumors may cause abnormal white blood cell and platelet counts or affect the function of the liver and kidneys.

4. Tumor marker detection

Catecholamine metabolites (such as adrenal medulla products): Neuroblastoma often secretes catecholamines (such as norepinephrine, epinephrine, etc.), and the metabolites of these substances (such as vanillylmandelic acid, syringic acid) can be detected through urine or blood as indicators of auxiliary diagnosis.

5. Histological examination

Final diagnosis usually requires histological examination, where tumor tissue is obtained for pathological evaluation.

Puncture biopsy: A sample is obtained through a fine needle puncture of tumor tissue for cytological examination. This is an important way to confirm the type and stage of the tumor.

Surgical resection: For tumors that can be surgically removed, doctors may recommend removing tumor samples directly during surgery for pathological examination. Through histological examination, doctors can determine the specific type of tumor, its degree of malignancy and whether it has metastasized.

6. Gene testing and molecular genetic examination

Genetic testing helps determine the molecular signature of tumors and can help guide treatment decisions, especially for high-risk types of neuroblastoma.

MYCNGene Amplification Test:MYCNGene amplification is an important biological marker in neuroblastoma and is often associated with highly aggressive tumors and poor prognosis.

ALKgene mutation detection:ALKgene mutations are related to some neuroblastomas, especially some familial cases. This mutation has important implications for targeted therapy.

Chromosome analysis: Chromosome analysis can detect some genetic abnormalities related to prognosis, such as 1p deletion and 11q deletion.

7. Clinical staging examination

Through the above series of examinations, doctors will formulate a specific treatment plan and clinically stage the tumor based on the size, location, whether it has metastasized, and the molecular characteristics of the tumor. This usually involves using an internationally standardized staging system such as the INSS or INRG staging system to evaluate the condition.

Diagnosing neuroblastoma in children requires a combination of multiple examination methods, including imaging examinations, laboratory tests, genetic testing and histological analysis. Timely and comprehensive diagnosis is crucial for selecting appropriate treatment options, determining prognosis, and evaluating treatment effects.

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ReferenceInformation：https://www.cancer.org/cancer/neuroblastoma.html