Neuroblastoma (NB), a sympathetic nervous system-derived tumor, is the second most frequent solid tumor of early childhood. This tumor shows a wide spectrum of clinical behaviors, from spontaneous regression of even widespread tumors to rapidly progressing, metastatic disease resistant to intensive chemo-and radiotherapy.1,2 There have been several parameters proposed to refine diagnosis and to predict biological behavior. In addition to stage, patient age, and histology, important prognostic indicators include ploidy, MYCN amplification (MNA), 1p deletion, 17q overrepresentation and alteration in neurotrophin receptor gene expression. [3][4][5][6][7] In localized and stage IVS NB, amplification of the MYCN proto-oncogene is a highly significant marker for a poor prognosis independent of other biological or clinical parameters and the risk of treatment failure in patients whose tumors display MNA is still very high. 8,9 Experiments with animal models as well as clinical observations have confirmed that MNA clearly contributes to the malignant phenotype of this disease.
10,11The MYCN oncogene is amplified in ϳ30% of advanced stage tumors as well as in most cell lines, typically derived from advanced stage tumors. As shown previously in vitro, extrachromosomal amplified genes in acentric double-minutes chromosomes (dmin) can be expelled from the nucleus and lost from the cell. Loss of amplified sequences is correlated with a loss of malignant properties and cellular differentiation.12-16 Expelled material is seen as micronuclei, small nuclear-like structures. Micronuclei can arise from the nucleus by budding during S phase 17 or after mitosis as the nuclear membrane reforms. They can contain not only amplified oncogenes but also acentric chromosome fragments or whole damaged chromosomes. 18,19 In this study we assayed 46 NB tumors for MNA, 1p, and 17q status. We found 11 tumors with MNA and in at least 8 of the 11 we observed micronuclei comprising amplified MYCN sequences. Our work is the second report of spontaneous elimination of amplified genes occurring in vivo from NB cells.