I concur with Mike Addison. Our experience is, as with Mike, that the best
combination of analytes is Dopamine and HVA. For that reason we dropped HMMA
from our list of assays a number of years ago. We also have age based
reference ranges for both 24 hour and creatinine ratios. My experience from
reporting both on 24 hour samples is that in some situations there is a
discrepancy between the two suggesting an inadequate or incomplete 24 hour
collection so my preference is the random urine expressed in terms of
creatinine ratio.
Peter Vervaart BAppSci MAIMS FAACB
Senior Scientist, Gastroenterology and Nutrition
Department of Clinical Biochemistry
Women's and Children's Health Care Network
Flemington Road
Parkville, Victoria, 3052
Australia
Phone: 613-9345 5906
Fax: 613-9349 1819
WWW: http://www.rch.unimelb.edu.au\biochem\gastro
----- Original Message -----
From: Mike Addison <[log in to unmask]>
To: <[log in to unmask]>
Cc: <[log in to unmask]>
Sent: Tuesday, December 07, 1999 8:14 PM
Subject: Re: neuroblastoma
> The question is not a simple one as neuroblastoma covers a span
> of related but different tumours with different biochemical profiles.
> Problems arise with extra-abdominal tumours as well as highly
> differentiated ones. There is also the problem of the type of
> collection random or timed (24 hour). I always think that the
> difficulties of collecting the latter are grossly exaggerated and I
> believe that small neuroblastomas are more likely to be missed
> with random urines.
>
> Our experience of several hundred cases is that a combination of
> dopamine and HVA with laboratory based age related reference
> ranges gives 98% sensitivity. The specificity depends on patients
> selected for test but there is no doubt the more analytes you
> measure the more false positives you get. There is a danger when
> using tests aimed more at phaeos of missing cases. The problem
> of non-secretors described in many series does not appear to be
> so great using the dopamine/HVA combination.
>
> My advice is where you do very few cases per year to send the
> samples to a paediatric laboratory.
>
> Mike Addison
> Dr G.Michael Addison
> Royal Manchester Children's Hospital
> Pendlebury
> Manchester M27 4HA
> United Kingdom
>
> Tel 0161-727-2250(AM)or 0161-220-5342(PM)
> FAX 0161-727-2249
> Email [log in to unmask]
>
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