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Screening for neuroblastoma in the northern region of England: laboratory aspects

Lookup NU author(s): Emeritus Professor Alan Craft, Professor Louise Parker, Mike Cole, Julian Smith


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Our pilot study for neuroblastoma screening started in 1986. The study has progressed through several phases, with use of several analytical methods to a procedure based primarily on the use of automated gas chromatography mass spectrometry. The northern region of England has a relatively static population of approximately 3.5 million, with an annual birth rate of 41,000. The region consists of 16 administrative health districts. In 4 years, we have screened 20,829 infants from four health districts. In this program, we screen all children at 6 months of age. A urine sample is collected on filter paper by a health visitor, either at the time of the infant's routine clinic visit or during the health visitor's follow-up visit at home. In the laboratory, the sample is dried and processed for analysis of homovanillic acid (HVA) and vanillylmandelic acid (VMA), using a benchtop Hewlett Packard gas chromatograph mass spectrometer. The results are related to the creatinine content of the urine. Using cut-off limits of 39 mug/mg of creatinine for HVA and 25 mug/mg of creatinine for VMA, 2,537 infants (12.2%) required a second paper sample and 527 infants (2.5%) were observed with a liquid urine collection. Of these, the conditions of nine infants with elevated levels of HVA or VMA were investigated clinically for the possible presence of neuroblastoma. Two infants were found to have neuroblastoma; the other seven showed no evidence of tumor. In addition, there were three children who, when screened at 6 months of age, had normal levels of HVA and VMA but in whom neuroblastoma subsequently developed.

Publication metadata

Author(s): Seviour JA, McGill AC, Craft AW, Parker L, Bell S, Cole M, Smith J, Hawkins E, Brown J, Dale GA

Publication type: Article

Publication status: Published

Journal: American Journal of Pediatric Hematology Oncology

Year: 1992

Volume: 14

Issue: 4

Pages: 332-336

Print publication date: 01/11/1992

ISSN (print): 0192-8562

ISSN (electronic):

PubMed id: 1456399