WOFAPS 2025 8th World Congress of Pediatric Surgery

Jyoti Sharma, Prabudh Goel, VIshesh Jain, Devendra Kumar Yadav, Anjan Kumar Dhua, Sandeep Agarwala

All India Institute of Medical Sciences, New Delhi

Background:
Neuroblastoma (NB) is the most common extracranial solid tumor in children and a major contributor to pediatric cancer mortality. It is characterized by clinical heterogeneity and poor prognosis in high-risk cases. While multimodal therapies have improved outcomes for some, the underlying molecular mechanisms remain incompletely defined. Long non-coding RNAs (lncRNAs), once considered transcriptional noise, are now recognized as key regulators of gene expression involved in tumorigenesis, metastasis, and drug resistance.

Objective:
This systematic review aimed to consolidate evidence on the roles, regulatory mechanisms, and clinical implications of lncRNAs in NB, focusing exclusively on studies using patient-derived human samples.

Methods:
A comprehensive search was conducted in PubMed and Web of Science (2015–2024), adhering to PRISMA 2020 guidelines. Studies evaluating lncRNA expression, function, or polymorphisms in NB using human tissues, serum, or patient datasets were included. Reviews, animal-only studies, and non-mechanistic reports were excluded. After screening 335 articles, 80 studies met the inclusion criteria.

Results:
Numerous lncRNAs were found to be dysregulated in NB. Oncogenic lncRNAs (e.g., NEAT1, MALAT1, SNHG1/7/16, XIST) and tumor suppressors (e.g., NBAT1, MEG3, CASC15, GAS5) modulate critical signaling pathways including PI3K/AKT/mTOR, p53, and Wnt/β-catenin. Several lncRNAs function as competing endogenous RNAs (ceRNAs), modulating miRNA activity and influencing proliferation, apoptosis, metastasis, and chemoresistance. Polymorphisms in lncRNAs such as LINC00673, MEG3, and HOTAIR were associated with NB risk and prognosis. Liquid biopsy-based detection of circulating lncRNAs also shows promise for early diagnosis. Prognostic lncRNA signatures were linked to overall survival and disease stage.

Conclusion:
LncRNAs are emerging as pivotal players in NB pathobiology. Their diagnostic, prognostic, and therapeutic potential warrants further clinical validation. Incorporating lncRNA profiling into current clinical workflows could enhance precision medicine strategies in neuroblastoma.