高效液相色谱法检测尿中儿茶酚胺代谢产物含量在神经母细胞瘤早期诊断中的价值

Signif icance of measuring urinary catecholamines metabol ites levels by high performance l iquid chromatography ( HPLC) in the early diagnosis of neuroblastoma

摘要:

目的 尿中香草扁桃酸 (VMA)及高香草酸 (HVA)的检测是目前早期诊断神经母细胞瘤 (NB)的重要指标 ,以前的检测方法干扰因素多 ,结果不够准确。该文探讨高效液相色谱法 (HPLC)检测随机尿中VMA、HVA的含量在NB诊断和早期诊断中的价值。方法 用HPLC方法 (流动相 pH4 .3,甲醇含量 2 % ,正辛烷磺酸钠溶液 3.0mmol/L)检测 5 0例正常儿童 (正常对照组 )、2 7例NB患儿 (NB组 )及 1 5例急性淋巴细胞性白血病患儿(ALL组 )随机尿中VMA、HVA浓度。用比色法测定同一样品中肌酐浓度。以VMA、HVA与肌酐的比值表示VMA、HVA含量。结果 NB组患儿随机尿VMA/Cr及HVA/Cr的含量 (5 1 .6 0± 4 .5 3μmol/ μmolCr,5 8.0 0±3.75 μmol/ μmolCr)明显高于正常对照组 (8.4 2± 3.6 1 μmol/ μmolCr,1 0 .1 2± 3.88μmol/ μmolCr)及ALL组患儿(8.78± 3.5 0 μmol/ μmolCr,1 1 .5 0± 2 .6 8μmol/ μmolCr) ,其差异均有显著性 (P <0 .0 5 )。以正常对照组儿童随机尿中VMA/Cr及HVA/Cr均值加 2 .5个标准差为异常判定值 ,分别为 1 7.5、1 9.8μmol/ μmolCr,超过此值为异常 ,则尿VMA/Cr或HVA/Cr异常对NB的诊断效率为 96 .3%。结论 HPLC同时测定随机尿中VMA、HVA含量 ,能为NB的早期诊断提供可靠的实验依据 ,并且可用于NB的诊断

Abstract:

The detection of the levels of urinary catecholamines metabolites, vanillylmandelic acid (VMA) and homovanillic acid (HVA), is an important approach to the early diagnosis of neuroblastoma (NB). The previous measurment of chromatometry, however, was usually affected by many factors as result of an inaccurate findings. This paper aims to study the significance of measuring urinary VMA and HVA levels in children by high performance liquid chromatography (HPLC) in the early diagnosis of NB. Methods Fifty healthy children (Normal control group), 27 children with NB (NB group) and 15 children with ALL (ALL group) were enrolled in this study. The levels of VMA and HVA in random urine were measured by HPLC with the flow phase of pH of 4.3 , 2% methanol and IPRB8 of 3.0 mmol/L and the creatin (Cr) level in random urine was measured by chromatometry. VMA and HVA were expressed as VMA/Cr and HVA/Cr. Results The values of VMA/Cr and HVA/Cr in random urine of the NB group ( 51.60 ± 4.53 and 58.00 ± 3.75 μmol/μmol Cr, respectively) were significantly higher than those of the Normal control group ( 8.42 ± 3.61 and 10.12 ± 3.88 μmol/μmol Cr, respectively) and the ALL group ( 8.78 ± 3.50 and 11.50 ± 2.68 μmol/μmol Cr, respectively) (P< 0.05 ). The values of VMA/Cr and HVA/Cr being higher than 17.5 μmol/μmol Cr and 19.8 μmol/μmol Cr respectively, the levels of those of the Normal control group plus 2 standard deviations, were considered as abnormal. As a result, the diagnosis rate of abnormal VMA or HVA for NB was 96.3% . Conclusions The detection of VMA and HVA levels in random urine by HPLC can provide reliable experimental evidence for early diagnosis and differential diagnosis of NB.