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ARTICLE

Diagnosis and Risk Assessment in Neuroblastoma: Current Evidence and a Pilot Retrospective Study

Małgorzata Mitura-Lesiuk1,*, Kamil Górecki2, Katarzyna Witczak2, Aleksandra Greluk2, Julia Zarychta1,3, Maciej Dubaj1,3
1 Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Lublin, Poland
2 Student Scientific Society of Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Lublin, Poland
3 Doctoral School, Medical University of Lublin, Lublin, Poland
* Corresponding Author: Małgorzata Mitura-Lesiuk. Email: email

Oncology Research https://doi.org/10.32604/or.2026.081326

Received 28 February 2026; Accepted 16 September 2026; Published online 22 September 2026

Abstract

Background: Neuroblastoma (NB) is a heterogeneous pediatric malignancy requiring accurate risk stratification. This study explored the relationship between conventional biomarkers and disease characteristics in a pediatric NB cohort and contextualized these findings with emerging evidence on non-coding RNA (ncRNA) biomarkers. Methods: We retrospectively analyzed 17 children with histologically confirmed NB treated at a single center. Associations between ferritin, neuron-specific enolase (NSE), disease stage, and N-Myc proto-oncogene (MYCN) amplification were evaluated using nonparametric methods and receiver operating characteristic (ROC) analysis. Recent evidence on ncRNA biomarkers in NB was additionally reviewed. Results: Ferritin showed exploratory discriminatory potential for advanced disease (International Neuroblastoma Staging System (INSS) stage IV/IVs vs. I–III), with an area under the curve (AUC) of 0.78 (95% confidence interval [CI], 0.41–1.00). A ROC-derived threshold of 322 ng/mL was identified for hypothesis-generating purposes. Ferritin was higher in the two MYCN-amplified cases, although the subgroup was too small for statistical inference, and correlated weakly with NSE (ρ = 0.29, p = 0.037). The literature review identified ncRNAs associated with aggressive and MYCN-driven NB phenotypes, supporting their potential role in future risk assessment. Conclusions: Ferritin may complement established markers in NB risk assessment, although these preliminary findings require validation in larger cohorts. Combining conventional biomarkers with ncRNA-based signatures may represent a promising strategy for future multimodal risk stratification.

Keywords

Neuroblastoma; child; diagnosis; risk factors; ferritin; neuron-specific enolase

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