Chronic diarrhea related to neuroblastoma: the important role of vasoactive intestinal peptide in tumor pathology and survival

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To analyze the correlation between vasoactive intestinal peptide (VIP) protein expression in neuroblastoma (NB) tumors and NB clinical features and prognosis. Clinical data were collected from 91 patients with NB aged < 18 years who underwent tumor resection at the Shengjing Hospital of China Medical University between January 2015 and December 2021. VIP expression levels in tumor tissues were evaluated by immunohistochemistry, and the correlation between VIP expression intensity and NB clinical characteristics and prognosis was analyzed. VIP expression was detected in 25/91 patients with NB (27.5%). VIP expression intensity was significantly increased in children with diarrhea and hypokalemia ( P < 0.001, and P < 0.001, respectively), and was significantly associated with histopathological classification, prognosis, bone marrow metastasis, and tumor stage ( P = 0.003, P = 0.036, P = 0.018, and P = 0.027, respectively). VIP expression intensity was positively correlated with synaptophysin expression (r s = 0.342, P = 0.001), and negatively correlated with expression of chromogranin A and proliferating cell nuclear antigen (Ki67) (r s = -0.265, P = 0.011; r s = -0.317, P = 0.002, respectively). There were no significant differences in VIP expression levels according to sex, age, tumor site, or levels of neuron specific enolase, 24-h urine vanillylmandelic acid, and lactate dehydrogenase. VIP is one of the main causes of refractory diarrhea in patients with NB, and may be a potential biomarker of good prognosis. Retrospectively registered.

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