Three years of experience with random urinary homovanillic and vanillylmandelic acid levels in the diagnosis of neuroblastoma.
During the last 3 years, random urine samples from 408 patients were tested for elevated homovanillic acid (HVA) and vanillylmandelic acid (VMA) levels to rule out the diagnosis of neuroblastoma. Thirty-seven of these patients had elevated HVA and/or VMA levels, and neuroblastoma was subsequently diagnosed. In three additional patients with negative test results (normal HVA and VMA levels), tumors were subsequently diagnosed (false-negative rate of 7.5%). Ten percent of the patients with neuroblastoma had normal HVA and 27.5% had normal VMA levels at the time of diagnosis. Only one patient (2.5%) with neuroblastoma had elevated VMA levels in the presence of normal HVA levels. More than 60% of the patients with neuroblastoma had urinary HVA and/or VMA levels higher than twice the upper limit of normal. No false-positive results were encountered. Age and stage distributions of the patients are shown, and the significance of the results is discussed.
D002675:Child, Preschool; D002849:Chromatography, Gas; D005188:False Negative Reactions; D006719:Homovanillic Acid / Q000652:urine*; D006801:Humans; D007223:Infant; D009447:Neuroblastoma / Q000652:urine*; D014642:Vanilmandelic Acid / Q000652:urine*
D014642:Vanilmandelic Acid; D006719:Homovanillic Acid