Background: Neuroblastoma (NB) is a childhood cancer of the sympathetic nervous system and its prognosis is dismal. The NB undergo transcription changes that use aerobic glycolysis as its primary metabolic pathway. Aerobic glycolysis is an immediate source of ATP for cancerous proliferation, and therefore maybe exploited for dietary therapies (i.e. ketone diet). The R2 database is a novel platform with gene expression and prognostic data on numerous primary tumor samples. This study investigates the gene expression of glycolytic and ketolytic genes in the context of MYCN amplification, international tumor staging, and Kaplan Meier survivability.

Methods: Six NB datasets were assessed on the R2: Genomics Analysis and Visualisation Platform. Kaplan Meier survival curves were generated on the R2 platform. The gene expression data for HK2, GAPDH, ENO1 glycolytic genes and BDH1, OXCT1, ACAT1 ketolytic genes were analyzed.

Results: The glycolytic gene expression is increased in MYCN amplified, tumorigenic stage samples, and worse event free survival. Interestingly, the ketolytic gene expression is lower in the tumorigenic stage and event free survivability associated with NB.  

Conclusions: The glycolytic gene expression profile of NB suggests that elevated levels correlate with tumorigenicity and low probability of survival. The ketolytic gene expression patterns suggest a decreased ketolytic reliance for energy and therefore may be exploited with a ketogenic diet to impede tumorigenic growth.