Nuttall K L, Pingree S S
Department of Pathology, University of Utah School of Medicine, Salt Lake City 84132, USA.
Ann Clin Lab Sci. 1998 May-Jun;28(3):167-74.
A 24-hour urine collection for 5-hydroxyindoleacetic acid (HIAA) is commonly performed to evaluate patients with suspected carcinoid syndrome. However, carcinoids are rare, and elevated results are common even when using an analytically specific method. To characterize this problem, the incidence of elevated results was examined in a population of 947 patient specimens received in a clinical reference laboratory setting. Using a reference limit of 15 mg/d identified 7.9 percent of the results as elevated, with 3 percent > 100 mg/d, and about 1 percent > 350 mg/d. Males showed 14 percent > 15 mg/d compared to 5.2 percent for females. Characterization of incomplete and excess 24-hr urine collections is facilitated by use of a creatinine ratio, with a reference limit of 14 mg/g creatinine equivalent to 15 mg/d. Given the frequency of elevated results, HIAA should be used to support the diagnoses of carcinoid only when consistent with other objective findings.
通常会进行24小时尿5-羟吲哚乙酸（HIAA）检测，以评估疑似类癌综合征的患者。然而，类癌较为罕见，即便采用分析特异性方法，检测结果升高的情况也很常见。为了明确这一问题，我们在临床参考实验室环境下，对947份患者样本进行检测，以检查结果升高的发生率。采用15mg/d的参考限值，7.9%的结果被判定为升高，其中3%大于100mg/d，约1%大于350mg/d。男性结果大于15mg/d的比例为14%，而女性为5.2%。使用肌酐比值有助于判断24小时尿液收集是否完整或过量，参考限值为14mg/g肌酐相当于15mg/d。鉴于结果升高的频率，仅当HIAA检测结果与其他客观发现一致时，才可用于辅助类癌的诊断。
