Measurement of urinary 5-HIAA: correlation between spot versus 24-h urine collection.
5-HIAA
5-hydroxyindoleacetic acid
carcinoid heart
carcinoid syndrome
neuroendocrine tumours
Journal
Endocrine connections
ISSN: 2049-3614
Titre abrégé: Endocr Connect
Pays: England
ID NLM: 101598413
Informations de publication
Date de publication:
01 Aug 2019
01 Aug 2019
Historique:
received:
03
06
2019
accepted:
01
07
2019
pubmed:
3
7
2019
medline:
3
7
2019
entrez:
3
7
2019
Statut:
ppublish
Résumé
The 24-h urinary output of 5-hydroxyindoleacetic acid (5-HIAA) is used to monitor disease progression and treatment responses of neuroendocrine neoplasms (NENs). Several conditions are required for 5-HIAA assay, involving urine collection/preservation and food/drug restrictions. To evaluate the correlation between 5-HIAA concentration in a spot urine sample and the output in a 24-h urine collection, and whether spot urine specimens can replace 24-h collection. Patients with NENs or symptoms suggestive of NENs were asked to provide a separate spot urine at the end of the 24-h urine collection for 5-HIAA assessment. The upper reference limit for 24-h urinary 5-HIAA was 40 µmol/24 h. 5-HIAA measurements in spot urine samples were corrected for variation in urine flow rate by expressing results as a ratio to creatinine concentration. We included 136 paired urinary samples for 5-HIAA assessment from 111 patients (100 NENs). The correlation between 5-HIAA values measured in 24-h and spot urines was r = +0.863 (P < 0.001) and r = +0.840 (P < 0.001) including only NEN patients. Using the 24-h urinary 5-HIAA as reference method, the AUC on ROC analysis for spot urinary 5-HIAA was 0.948 (95% CI, 0.914-0.983; P < 0.001), attaining a sensitivity of 83% and specificity of 95% using 5.3 mol/mmol as cut-off for the spot urine. The AUC among NEN patients alone was 0.945 (95% CI, 0.904-0.987; P < 0.001). The ratio of 5-HIAA to creatinine in a spot urine could replace the measurement of 5-HIAA output in a 24-h urine collection, especially for follow-up of patients with known elevated 5-HIAA levels.
Sections du résumé
BACKGROUND
BACKGROUND
The 24-h urinary output of 5-hydroxyindoleacetic acid (5-HIAA) is used to monitor disease progression and treatment responses of neuroendocrine neoplasms (NENs). Several conditions are required for 5-HIAA assay, involving urine collection/preservation and food/drug restrictions.
AIM
OBJECTIVE
To evaluate the correlation between 5-HIAA concentration in a spot urine sample and the output in a 24-h urine collection, and whether spot urine specimens can replace 24-h collection.
METHODS
METHODS
Patients with NENs or symptoms suggestive of NENs were asked to provide a separate spot urine at the end of the 24-h urine collection for 5-HIAA assessment. The upper reference limit for 24-h urinary 5-HIAA was 40 µmol/24 h. 5-HIAA measurements in spot urine samples were corrected for variation in urine flow rate by expressing results as a ratio to creatinine concentration.
RESULTS
RESULTS
We included 136 paired urinary samples for 5-HIAA assessment from 111 patients (100 NENs). The correlation between 5-HIAA values measured in 24-h and spot urines was r = +0.863 (P < 0.001) and r = +0.840 (P < 0.001) including only NEN patients. Using the 24-h urinary 5-HIAA as reference method, the AUC on ROC analysis for spot urinary 5-HIAA was 0.948 (95% CI, 0.914-0.983; P < 0.001), attaining a sensitivity of 83% and specificity of 95% using 5.3 mol/mmol as cut-off for the spot urine. The AUC among NEN patients alone was 0.945 (95% CI, 0.904-0.987; P < 0.001).
CONCLUSIONS
CONCLUSIONS
The ratio of 5-HIAA to creatinine in a spot urine could replace the measurement of 5-HIAA output in a 24-h urine collection, especially for follow-up of patients with known elevated 5-HIAA levels.
Identifiants
pubmed: 31265996
doi: 10.1530/EC-19-0269
pii: EC-19-0269
pmc: PMC6652243
doi:
pii:
Types de publication
Journal Article
Langues
eng
Pagination
1082-1088Références
J Chromatogr B Analyt Technol Biomed Life Sci. 2010 Mar 1;878(7-8):695-9
pubmed: 20117968
Neuroendocrinology. 2015;101(4):263-73
pubmed: 25871411
Int J Cancer. 2018 Mar 15;142(6):1139-1147
pubmed: 29082524
Endocr Pract. 2018 Aug;24(8):710-717
pubmed: 30084688
Ann Oncol. 2017 Jul 1;28(7):1582-1589
pubmed: 28444105
Pancreas. 2017 Jul;46(6):707-714
pubmed: 28609356
Circulation. 2005 Nov 22;112(21):3320-7
pubmed: 16286584
Eur J Endocrinol. 2016 Nov;175(5):361-6
pubmed: 27491374
Int J Gynecol Cancer. 2018 Mar;28(3):466-471
pubmed: 29420361
Curr Treat Options Cardiovasc Med. 2013 Oct;15(5):544-55
pubmed: 23955119
Ann Clin Biochem. 2016 Sep;53(Pt 5):554-60
pubmed: 26438520
Gut. 2006 Nov;55(11):1586-91
pubmed: 16556667
Gut. 2012 Jan;61(1):6-32
pubmed: 22052063
Lancet Oncol. 2017 Apr;18(4):525-534
pubmed: 28238592
Clin Chem. 2000 Oct;46(10):1588-96
pubmed: 11017936
JAMA Oncol. 2017 Oct 1;3(10):1335-1342
pubmed: 28448665
Clin Chem. 2002 Nov;48(11):2049-51
pubmed: 12406994
Clin Chem. 1992 Sep;38(9):1730-6
pubmed: 1382000
Clin Chem. 2004 Sep;50(9):1634-9
pubmed: 15247155
Neuroendocrinology. 2017 Apr 8;105(3):201-211
pubmed: 28391265
Clin Chem. 1986 May;32(5):840-4
pubmed: 2421946
Eur J Cancer. 2007 Dec;43(18):2651-7
pubmed: 17825550
Endocr Connect. 2017 Aug;6(6):R87-R98
pubmed: 28566493
Endocr Pract. 2018 Aug 7;:
pubmed: 30084687
Ann Clin Biochem. 1996 Jan;33 ( Pt 1):43-9
pubmed: 8929065
Nat Rev Endocrinol. 2009 May;5(5):276-83
pubmed: 19444261
Br J Cancer. 2007 Apr 23;96(8):1178-82
pubmed: 17406366
Cancer. 2003 Feb 15;97(4):934-59
pubmed: 12569593
Ann Clin Biochem. 2000 Sep;37 ( Pt 5):724-6
pubmed: 11026528
Neuroendocrinology. 2018;107(1):32-41
pubmed: 29539613
Pancreas. 2013 Apr;42(3):405-10
pubmed: 23160483
Cancer. 2015 Feb 15;121(4):589-97
pubmed: 25312765
Endocr Connect. 2013 Jan 25;2(1):50-4
pubmed: 23781318
Neuroendocrinology. 2018;107(3):292-304
pubmed: 30153671
J Am Coll Cardiol. 2017 Mar 14;69(10):1288-1304
pubmed: 28279296