Krstulovic A M, Zakaria M, Lohse K, Bertani-Dziedzic L
J Chromatogr. 1979 Dec 30;186:733-48. doi: 10.1016/s0021-9673(00)95292-0.
Aberrations in the metabolic pathways of catecholamines in patients with neural crest tumors result in characteristic urinary excretion patterns of their catabolites. Tumors such as pheochromocytoma, neuroblastoma and ganglioneuroma usually defy clinical diagnosis because of their rarity, small size, intraabdominal position and clinical symptoms similar to those of essential hypertension. Quantitative determination of catecholamine metabolites such as vanillylmandelic acid (VMA) and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) offers possibilities for reliable confirmation of diagnosis. However, previous techniques for the assessment of catabolite levels suffered from inadequate sensitivity, reproducibility or specificity, which seriously diminished their usefulness as biochemical determinants in the prognosis of these life-threatening tumors. Reported in this paper is the analysis of urinary levels of VMA and MHPG using reversed-phase high-performance liquid chromatography with electrochemical and sectrophotometric detection. We present the excretion patterns showing these metabolites in 15 control subjects, 15 patients with pheochromocytoma and 5 patients with neuroblastoma.
神经嵴肿瘤患者儿茶酚胺代谢途径的异常会导致其分解代谢产物出现特征性的尿排泄模式。诸如嗜铬细胞瘤、神经母细胞瘤和神经节神经瘤等肿瘤，由于其罕见性、体积小、位于腹腔内以及临床症状与原发性高血压相似，通常难以进行临床诊断。对香草扁桃酸（VMA）和3-甲氧基-4-羟基苯乙二醇（MHPG）等儿茶酚胺代谢产物进行定量测定，为可靠确诊提供了可能。然而，以往评估分解代谢产物水平的技术存在灵敏度不足、重现性差或特异性不强的问题，这严重降低了它们作为这些危及生命肿瘤预后生化指标的实用性。本文报道了采用反相高效液相色谱法结合电化学和分光光度检测法对尿中VMA和MHPG水平进行的分析。我们展示了15名对照受试者、15名嗜铬细胞瘤患者和5名神经母细胞瘤患者中这些代谢产物的排泄模式。
