Catecholamines profiles at diagnosis: Increased diagnostic sensitivity and correlation with biological and clinical features in neuroblastoma patients.

Abstract

INTRODUCTION:

Neuroblastoma (NBL) accounts for 10% of the paediatric malignancies and is responsible for 15% of the paediatric cancer-related deaths. Vanillylmandelic acid (VMA) and homovanillic acid (HVA) are most commonly analysed in urine of NBL patients. However, their diagnostic sensitivity is suboptimal (82%). Therefore, we performed in-depth analysis of the diagnostic sensitivity of a panel of urinary catecholamine metabolites.

PATIENTS AND METHODS:

Retrospective study of a panel of 8 urinary catecholamine metabolites (VMA, HVA, 3-methoxytyramine [3MT], dopamine, epinephrine, metanephrine, norepinephrine and normetanephrine [NMN]) from 301 NBL patients at diagnosis. Special attention was given to subgroups, metaiodobenzylguanidine (MIBG) non-avid tumours and VMA/HVA negative patients.

RESULTS:

Elevated catecholamine metabolites, especially 3MT, correlated with nine out of 12 NBL characteristics such as stage, age, MYCN amplification, loss of heterozygosity for 1p and bone-marrow invasion. The combination of the classical markers VMA and HVA had a diagnostic sensitivity of 84%. NMN was the most sensitive single diagnostic metabolite with overall sensitivity of 89%. When all 8 metabolites were combined, a diagnostic sensitivity of 95% was achieved. Among the VMA and HVA negative patients, were also 29% with stage 4 disease, which usually had elevation of other catecholamine metabolites (93%). Diagnostic sensitivity for patients with MIBG non-avid tumour was improved from 33% (VMA and/or HVA) to 89% by measuring the panel.

CONCLUSIONS:

Our study demonstrates that analysis of a urinary catecholamine metabolite panel, comprising 8 metabolites, ensures the highest sensitivity to diagnose NBL patients.

• Authors: Iedan R N Verly, André B P van Kuilenburg, Nico G G M Abeling, Susan M I Goorden, Marta Fiocco, Frédéric M Vaz, Max M van Noesel, C Michel Zwaan, GertJan L Kaspers, Johannes H M Merks, Huib N Caron, Godelieve A M Tytgat
• Journal: European journal of cancer (Oxford, England : 1990) (Eur J Cancer) Vol. 72 Pg. 235-243 (02 2017) ISSN: 1879-0852 [Electronic] England
• PMID: 28061374 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2016 Elsevier Ltd. All rights reserved.

Chemical References

• Biomarkers, Tumor
• Catecholamines

Topics

• Adolescent
• Biomarkers, Tumor (urine)
• Catecholamines (metabolism, urine)
• Child
• Child, Preschool
• Female
• Humans
• Infant
• Infant, Newborn
• Male
• Neuroblastoma (urine)
• Retrospective Studies
• Sensitivity and Specificity