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Li H, Zhang G, Wang W, Jiao LL, Chen CB, Huo JR, Wu W. Detection of catecholamine metabolites in urine based on ultra-high-performance liquid chromatography-tandem mass spectrometry. Biomed Chromatogr 2021; 36:e5280. [PMID: 34788895 DOI: 10.1002/bmc.5280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/15/2021] [Accepted: 11/04/2021] [Indexed: 11/09/2022]
Abstract
The excretion of neurotransmitter metabolites in normal individuals is of great significance for health monitoring. A rapid quantitative method was developed with ultra-performance liquid chromatography-tandem mass spectrometry. The method was further applied to determine catecholamine metabolites vanilymandelic acid (VMA), methoxy hydroxyphenyl glycol (MHPG), dihydroxy-phenyl acetic acid (DOPAC), and homovanillic acid (HVA) in the urine. The urine was collected from six healthy volunteers (20-22 years old) for 10 consecutive days. It was precolumn derivatized with dansyl chloride. Subsequently, the sample was analyzed using triple quadrupole mass spectrometry with an electrospray ion in positive and multireaction monitoring modes. The method was sensitive and repeatable with the recoveries 92.7-104.30%, limits of detection (LODs) 0.01-0.05 μg/mL, and coefficients no less than 0.9938. The excretion content of four target compounds in random urine samples was 0.20 ± 0.086 μg/mL (MHPG), 1.27 ± 1.24 μg/mL (VMA), 3.29 ± 1.36 μg/mL (HVA), and 1.13 ± 1.07 μg/mL (DOPAC). In the urine, the content of VMA, the metabolite of norepinephrine and adrenaline, was more than MHPG, and the content of HVA, the metabolite of dopamine, was more than DOPAC. This paper detected the levels of catecholamine metabolites and summarized the characteristics of excretion using random urine samples, which could provide valuable information for clinical practice.
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Affiliation(s)
- Hui Li
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Guolei Zhang
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Wei Wang
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Li-Li Jiao
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Chang-Bao Chen
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Jing-Rui Huo
- Cangzhou Nanobody Technology Innovation Center, Cangzhou Medical College, Cangzhou, China
| | - Wei Wu
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
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Application of an LC-MS/MS Method for the Simultaneous Quantification of Homovanillic Acid and Vanillylmandelic Acid for the Diagnosis and Follow-Up of Neuroblastoma in 357 Patients. Molecules 2021; 26:molecules26113470. [PMID: 34200415 PMCID: PMC8201085 DOI: 10.3390/molecules26113470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 11/22/2022] Open
Abstract
Homovanillic acid (HVA) and vanillylmandelic acid (VMA) are end-stage metabolites of catecholamine and are clinical biomarkers for the diagnosis of neuroblastoma. For the first time in Korea, we implemented and validated a liquid chromatography tandem mass spectrometry (LC–MS/MS) assay to measure urinary concentrations of HVA and VMA according to Clinical and Laboratory Standards Institute guidelines. Our LC–MS/MS assay with minimal sample preparation was validated for linearity, lower limit of detection (LOD), lower limit of quantification (LLOQ), precision, accuracy, extraction recovery, carryover, matrix effect, and method comparison. A total of 1209 measurements was performed to measure HVA and VMA in spot urine between October 2019 and September 2020. The relationship between the two urinary markers, HVA and VMA, was analyzed and exhibited high agreement (89.1% agreement, kappa’s k = 0.6) and a strong correlation (Pearson’s r = 0.73). To our knowledge, this is the first study to utilize LC–MS/MS for simultaneous quantitation of spot urinary HVA and VMA and analyze the clinical application of both markers on a large scale for neuroblastoma patients.
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Young SP, Khan A, Stefanescu E, Seifts AM, Hijazi G, Austin S, Kishnani PS. Diurnal variability of glucose tetrasaccharide (Glc 4) excretion in patients with glycogen storage disease type III. JIMD Rep 2021; 58:37-43. [PMID: 33728245 PMCID: PMC7932871 DOI: 10.1002/jmd2.12181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/27/2020] [Accepted: 10/22/2020] [Indexed: 11/08/2022] Open
Abstract
AIM The urinary glucose tetrasaccharide, Glcα1-6Glcα1-4Glcα1-4Glc (Glc4), is a glycogen limit dextrin that is elevated in patients with glycogen storage disease (GSD) type III. We evaluated the potential of uncooked cornstarch therapy to interfere with Glc4 monitoring, by measuring the diurnal variability of Glc4 excretion in patients with GSD III. METHODS Voids were collected at home over 24 hours, stored at 4°C and frozen within 48 hours. Glc4 was analyzed using liquid chromatography-tandem mass spectrometry and normalized to creatinine. RESULTS Subjects with GSD III (median age: 13.5 years, range: 3.7-62; n = 18) completed one or more 24-hour urine collection, and 28/36 collections were accepted for analysis. Glc4 was elevated in 16/18 subjects (median: 13 mmol/mol creatinine, range: 2-75, reference range: <3). In collections with elevated Glc4 (23/28), two-thirds (15/23) had low diurnal variability in Glc4 excretion (coefficient of variation [CV%] <25). The diurnal variability was significantly correlated with the Glc4 concentration (Pearson R = .644, P < .05), but not with the dose of uncooked cornstarch. High intraday variability (>25%) was not consistently observed in repeat collections by the same subject. CONCLUSIONS The extent and variability of Glc4 excretion relative to creatinine was not correlated with cornstarch dose. A majority of collections showed low variability over 24 hours. These findings support the use of single time-point collections to evaluate Glc4 in patients with GSD III treated with cornstarch. However, repeat sampling over short time-periods will provide the most accurate assessment of Glc4 excretion, as intraday variability may be increased in patients with high Glc4 excretion.
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Affiliation(s)
- Sarah P. Young
- Division of Medical Genetics, Department of PediatricsDuke University School of MedicineDurhamNorth CarolinaUSA
- Duke University Health System Biochemical Genetics LaboratoryDurhamNorth CarolinaUSA
| | - Aleena Khan
- Division of Medical Genetics, Department of PediatricsDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Ela Stefanescu
- Division of Medical Genetics, Department of PediatricsDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Andrea M. Seifts
- Duke University Health System Biochemical Genetics LaboratoryDurhamNorth CarolinaUSA
| | - Ghada Hijazi
- Division of Medical Genetics, Department of PediatricsDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Stephanie Austin
- Division of Medical Genetics, Department of PediatricsDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Priya S. Kishnani
- Division of Medical Genetics, Department of PediatricsDuke University School of MedicineDurhamNorth CarolinaUSA
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Ferraro S, Braga F, Luksch R, Terenziani M, Caruso S, Panteghini M. Measurement of Serum Neuron-Specific Enolase in Neuroblastoma: Is There a Clinical Role? Clin Chem 2020; 66:667-675. [DOI: 10.1093/clinchem/hvaa073] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2020] [Indexed: 12/21/2022]
Abstract
Abstract
BACKGROUND
The measurement of neuron-specific enolase (NSE) in serum is frequently requested for diagnosis, risk stratification, and treatment monitoring of neuroblastoma (NB) in the pediatric population. However, authoritative clinical practice guidelines advise about the poor diagnostic performance of NSE.
Content
We critically appraised the available literature evaluating the diagnostic and prognostic value of NSE in the management of NB, paying special attention to the definition of appropriate threshold levels. In addition, we discuss the interfering conditions causing artifactual increases of NSE concentrations in serum and potentially influencing the clinical evaluation of patients with suspected NB.
Summary
No definitive evidence supports the use of serum NSE for diagnosis and monitoring of NB. The risk of obtaining false-positive NSE results associated with confounders (e.g., sample hemolysis) and other pathophysiologic conditions (e.g., inflammation) is remarkable and hampers the diagnostic value of this test. NSE may be helpful to define the risk of death of patients with NB, mainly in the advanced stages of disease. However, further studies validating currently marketed immunoassays and defining threshold values useful for this scope are warranted.
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Affiliation(s)
- Simona Ferraro
- Unità Operativa Complessa Patologia Clinica, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Federica Braga
- Unità Operativa Complessa Patologia Clinica, ASST Fatebenefratelli-Sacco, Milano, Italy
- Dipartimento di Scienze Biomediche e Cliniche, “Luigi Sacco,” Università degli Studi, Milano, Italy
| | - Roberto Luksch
- Struttura Complessa Pediatria Oncologica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Monica Terenziani
- Struttura Complessa Pediatria Oncologica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Simone Caruso
- Unità Operativa Complessa Patologia Clinica, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Mauro Panteghini
- Unità Operativa Complessa Patologia Clinica, ASST Fatebenefratelli-Sacco, Milano, Italy
- Dipartimento di Scienze Biomediche e Cliniche, “Luigi Sacco,” Università degli Studi, Milano, Italy
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Takekoshi K, Satoh F, Tanabe A, Okamoto T, Ichihara A, Tsuiki M, Katabami T, Nomura M, Tanaka T, Matsuda T, Imai T, Yamada M, Asada S, Kawata N, Naruse M. Correlation between urinary fractionated metanephrines in 24-hour and spot urine samples for evaluating the therapeutic effect of metyrosine: a subanalysis of a multicenter, open-label phase I/II study. Endocr J 2019; 66:1063-1072. [PMID: 31511435 DOI: 10.1507/endocrj.ej19-0125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We recently conducted an open-label phase I/II study to evaluate the efficacy and safety of preoperative and chronic treatment with metyrosine (an inhibitor of catecholamine synthesis) in pheochromocytoma/paraganglioma (PPGL) in Japan. We compared creatinine-corrected metanephrine fractions in spot urine and 24-hour urine samples (the current standard for the screening and diagnosis of PPGLs) from 16 patients to assess the therapeutic effect of metyrosine. Percent changes from baseline in urinary metanephrine (uMN) or normetanephrine (uNMN) were compared between spot and 24-hour urine samples. Mean percent changes in uMN or uNMN in spot and 24-hour urine were -26.36% and -29.27%, respectively. The difference in the percent change from baseline between uMN or uNMN in spot and 24-hour urine was small (-2.90%). The correlation coefficient was 0.87 for percent changes from baseline between uMN or uNMN measured in spot and 24-hour urine. The area under the receiver operator characteristic (ROC) curve of uMN or uNMN measured in spot urine vs. 24-hour urine (reference standard) to assess the efficacy of metyrosine treatment was 0.93. Correlations and ROCs between 24-hour urinary vanillylmandelic acid, adrenaline, and noradrenaline and 24-hour uMN or uNMN were similar to those between spot uMN or uNMN and 24-hour uMN or uNMN. No large difference was observed between spot and 24-hour urine for the assessment of metyrosine treatment by quantifying uMN or uNMN in Japanese patients with PPGLs. These results suggest that spot urine samples may be useful in assessing the therapeutic effect of metyrosine.
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Affiliation(s)
- Kazuhiro Takekoshi
- Division of Sports Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Fumitoshi Satoh
- Division of Clinical Hypertension, Endocrinology & Metabolism, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai 980-8574, Japan
| | - Akiyo Tanabe
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Takahiro Okamoto
- Department of Surgery II, Tokyo Women's Medical University, Tokyo 162-8666, Japan
| | - Atsuhiro Ichihara
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Tokyo 162-8666, Japan
| | - Mika Tsuiki
- Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
| | - Takuyuki Katabami
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama 241-0811, Japan
| | - Masatoshi Nomura
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Tomoaki Tanaka
- Department of Molecular Diagnosis, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Tadashi Matsuda
- Department of Urology and Andrology, Kansai Medical University, Hirakata 573-1010, Japan
| | - Tsuneo Imai
- National Hospital Organization, Higashinagoya National Hospital, Nagoya 465-8620, Japan
| | - Masanobu Yamada
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan
| | - Suguru Asada
- Data Science Development Headquarters, Ono Pharmaceutical Co., Ltd., Osaka 541-8564, Japan
| | - Nobuyuki Kawata
- Clinical Development Planning, Ono Pharmaceutical Co., Ltd., Osaka 541-8564, Japan
| | - Mitsuhide Naruse
- Clinical Research Institute for Endocrinology and Metabolic Diseases, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
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Ruan Y, Shi P, Lei Y, Weng S, Li S, Huang L, Lin X, Yao H. Polyvinyl butyral/graphene oxide nanocomposite modified electrode for the integrate determination of terminal metabolites of catecholamines in human urine. J Electroanal Chem (Lausanne) 2019. [DOI: 10.1016/j.jelechem.2019.113267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Grouzmann E, Centeno C, Eugster PJ. Quantification of vanillylmandelic acid, homovanillic acid and 5-hydroxyindoleacetic acid in urine using a dilute-and-shoot and ultra-high pressure liquid chromatography tandem mass spectrometry method. Clin Chem Lab Med 2019; 56:1533-1541. [PMID: 29708876 DOI: 10.1515/cclm-2017-1120] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/27/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) are biomarkers for the diagnosis and follow-up of neuroblastoma, whereas urinary 5-hydroxyindoleacetic acid (5-HIAA) is used to assess a carcinoid tumor. These analytes are conventionally analyzed in a single run by chromatography (LC) coupled with electrochemical detection (LC-ECD) using commercial kits. A rapid dilute-and-shoot LC tandem mass spectrometry (LC-MS/MS) assay was validated in order to replace the LC-ECD method and therefore improve analytical specificity and throughput. METHODS Sample preparation was carried out by dilution of the urine sample with a solution containing the deuterated internal standards. The separation was achieved on an ultra-high pressure LC system with MS detection using a triple quadrupole mass spectrometer. The method was validated according to the current EMA and FDA guidelines. RESULTS The full chromatographic run was achieved in 8 min. The method validation showed excellent linearity (r2>0.999 for all three analytes), precision (CV <15%), negligible matrix effect (recoveries >90%), low carryover (<1%) and LLOQ of 0.25, 0.4 and 0.4 μM for VMA, HVA and 5-HIAA, respectively. Deming fits and Bland-Altman analyses showed no significant differences between the values obtained between the two assays. CONCLUSIONS The LC-MS/MS method proposed in this study is fast and robust, and the simple sample preparation saves time and avoids the additional costs of dedicated kits used for the LC-ECD assays by switching to LC-MS/MS. Additionally, the near-perfect correlation observed herein between both assays allows the previously established reference ranges to be maintained.
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Affiliation(s)
- Eric Grouzmann
- Laboratoire des Catecholamines et Peptides, Service de Pharmacologie Clinique, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Catherine Centeno
- Laboratoire des Catecholamines et Peptides, Service de Pharmacologie Clinique, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Philippe J Eugster
- Laboratoire des Catecholamines et Peptides, Service de Pharmacologie Clinique, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Radhakrishnan V, Raja A, Dhanushkodi M, Ganesan TS, Selvaluxmy G, Sagar TG. Real World Experience of Treating Neuroblastoma: Experience from a Tertiary Cancer Centre in India. Indian J Pediatr 2019; 86:417-426. [PMID: 30778950 DOI: 10.1007/s12098-018-2834-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 12/03/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Management of neuroblastoma, especially high-risk (HR) disease is difficult in a resource-limited setting. There is a paucity of literature on outcomes of patients treated in India. The present study was conducted to analyse the clinical profile, treatment, and outcomes of patients with neuroblastoma treated at authors' centre. METHODS The study was a retrospective analysis of newly diagnosed patients with neuroblastoma treated at authors' centre between 2000 to 2017. The International Neuroblastoma Staging System and risk grouping were used to classify patients as low-risk (LR), intermediate-risk (IR) and high-risk (HR). Treatment was individualised and risk-adapted. Kaplan-Meier method was used to calculate the event-free survival (EFS) and overall survival (OS). RESULTS The study included 85 patients with a median age of 4 y and 67% were males. Malnutrition was observed in 55% of patients. Adrenal gland was the most common site in 75% patients followed by mediastinum in 12%. LR was observed in 7/85 (8%) patients, IR 20/85 (24%) and HR in 58/85 (68%) patients. The CCG-3891 protocol was used to treat 80% of the patients. Autologous stem cell transplantation (ASCT) was performed in 32% of HR patients. The median follow-up was 16.6 mo. The median EFS and OS for all patients were 19.2 mo and 26.9 mo respectively and the 3 y EFS and OS was 36% and 47% respectively. The 3y EFS for LR, IR and HR patients was 100%, 54%, and 18.9% respectively (P < 0.001) and for OS was 100%, 77%, and 34% respectively (P = 0.002). On multivariate analysis, a hemoglobin less than 10 g% predicted inferior EFS (P = 0.002) and OS (p = 0.005) for all patients. For patients with high-risk disease, on multivariate analysis, hemoglobin (P = 0.002) and 13-Cis Retinoic acid maintenance (P = 0.002) predicted EFS and only radiotherapy to the primary (P = 0.01) predicted OS. Only 4/19 (21%) are alive and in remission post ASCT. CONCLUSIONS Majority of patients with neuroblastoma presented to authors' centre with advanced disease. Survival outcomes of patients with LR disease are excellent. However, patients with HR disease have poor outcomes despite multimodality management. Non-availability of N-MYC testing in few patients could have falsely down-staged them to IR from HR. A low hemoglobin at diagnosis is a poor predictor of outcome.
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Affiliation(s)
| | - Anand Raja
- Department of Surgical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamilnadu, India
| | - Manikandan Dhanushkodi
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamilnadu, India
| | - T S Ganesan
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamilnadu, India
| | - G Selvaluxmy
- Department of Radiotherapy, Cancer Institute (WIA), Adyar, Chennai, Tamilnadu, India
| | - T G Sagar
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamilnadu, India
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Park E, Park H, Cho H, Ma Y, Lee SY, Lee JW, Yoo KH, Sung KW, Koo HH. Clinical Significance of Random Urinary Vanillylmandelic Acid in Patients with Neuroblastoma. CLINICAL PEDIATRIC HEMATOLOGY-ONCOLOGY 2018. [DOI: 10.15264/cpho.2018.25.2.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Esther Park
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyojung Park
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Heewon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Youngeun Ma
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Youn Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Won Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keon Hee Yoo
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Woong Sung
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hong Hoe Koo
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Shores DR, Everett AD. Children as Biomarker Orphans: Progress in the Field of Pediatric Biomarkers. J Pediatr 2018; 193:14-20.e31. [PMID: 29031860 PMCID: PMC5794519 DOI: 10.1016/j.jpeds.2017.08.077] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/04/2017] [Accepted: 08/30/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Darla R Shores
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.
| | - Allen D Everett
- Division of Cardiology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
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12
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Mass spectrometry of gangliosides in extracranial tumors: Application to adrenal neuroblastoma. Anal Biochem 2016; 509:1-11. [DOI: 10.1016/j.ab.2016.06.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 12/25/2022]
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13
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Barco S, Gennai I, Reggiardo G, Galleni B, Barbagallo L, Maffia A, Viscardi E, De Leonardis F, Cecinati V, Sorrentino S, Garaventa A, Conte M, Cangemi G. Urinary homovanillic and vanillylmandelic acid in the diagnosis of neuroblastoma: report from the Italian Cooperative Group for Neuroblastoma. Clin Biochem 2014; 47:848-52. [PMID: 24769278 DOI: 10.1016/j.clinbiochem.2014.04.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/08/2014] [Accepted: 04/13/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Urinary homovanillic and vanillylmandelic acid (HVA and VMA) are well known biomarkers for the management of neuroblastoma (NB). Very few and contradictory publications on their diagnostic performance are present in the literature. The aim of this study is to review the results of HVA/Cr and VMA/Cr obtained by the reference laboratory of the Italian Cooperative Group for NB within a 7-year period using HPLC-EC. PROCEDURE Updated reference intervals based on age as a continuous variable were calculated by using a multivariate statistical analysis. The diagnostic performance of the two biomarkers has been established by calculating their specificity and sensitivity and by receiver operating characteristics (ROC) curves for different ages and stages of disease. RESULTS Accurate age-related reference intervals were obtained from 648 HVA/Cr and 671 VMA/Cr results derived from patients in which the diagnosis of neuroendocrine tumors was excluded. Sensitivity, specificity and ROC curves were obtained from 169 HVA/Cr and 179 VMA/Cr results from confirmed NB patients. The best diagnostic performance was obtained in stage 4S tumors and in children <18months. CONCLUSIONS This is the first report, to our knowledge, that analyzes in depth the diagnostic performance of HVA/Cr and VMA/Cr for NB in different stages and age subgroups. In addition, the present work provides cut-off points able to discriminate between NB patients and negative subjects suspected to have NB and could be of help in taking medical decisions.
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Affiliation(s)
- Sebastiano Barco
- Clinical Pathology Laboratory Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Iulian Gennai
- Clinical Pathology Laboratory Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Giorgio Reggiardo
- Department of Biostatistics, Mediservice s.r.l., World Trade Center, Via De Marini 1, Genoa, Italy
| | - Barbara Galleni
- Department of Hematology-Oncology, Istituto Giannina Gaslini, Genoa, Italy
| | - Laura Barbagallo
- Clinical Pathology Laboratory Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Angelo Maffia
- Clinical Pathology Laboratory Unit, Istituto Giannina Gaslini, Genoa, Italy
| | | | | | - Valerio Cecinati
- Division of Pediatric Hematology and Oncology, Department of Hematology, Santo Spirito Hospital, Pescara, Italy
| | | | - Alberto Garaventa
- Department of Hematology-Oncology, Istituto Giannina Gaslini, Genoa, Italy
| | - Massimo Conte
- Department of Hematology-Oncology, Istituto Giannina Gaslini, Genoa, Italy
| | - Giuliana Cangemi
- Clinical Pathology Laboratory Unit, Istituto Giannina Gaslini, Genoa, Italy.
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