Comparison of Serum and Urinary 5-Hydroxyindoleacetic Acid as Biomarker for Neuroendocrine Neoplasms
Open Access
- 8 June 2021
- journal article
- research article
- Published by The Endocrine Society in Journal of the Endocrine Society
- Vol. 5 (8), bvab106
- https://doi.org/10.1210/jendso/bvab106
Abstract
Context Patients with serotonin-secreting neuroendocrine neoplasms (NENs) have increased serum 5-hydroxyindoleacetic acid (5HIAA) concentrations. Serum 5HIAA thus serves as a biomarker in NEN. Objective To evaluate an improved tandem mass spectrometric serum 5HIAA assay for diagnosis and follow-up of NEN in a clinical cohort. Design A retrospective study during 2016-2018 at the Diagnostic Center and Department of Endocrinology at Helsinki University Hospital, Finland. Methods Detailed patient data was obtained from 116 patients. Serum 5HIAA was analyzed by 2 different liquid chromatography with tandem mass spectrometry (LC-MS/MS) assays with samples prepared either by protein precipitation or solid phase extraction. Twenty-four–hour urine 5HIAA samples (n = 33) were analyzed by amperometric LC, and the results were compared. Specificity and sensitivity were calculated by receiver operating characteristic (ROC) analysis. Results We achieved 5 to10 000 nmol/L linearity and ≤2.5% variation with our new serum 5HIAA assay. In ROC analysis, the area under curve was 85% by serum assays [upper reference limit (URL) value 123 nmol/L] and 88% by the 24-h urine 5HIAA assay (URL value of 47.1 µmol), respectively. A difference (P < 0.001) between patients with active NEN and patients in remission was found by all 5HIAA assays. Conclusion Serum 5HIAA by LC-MS/MS after protein precipitation performs equally well for the diagnosis of NEN as urinary 5HIAA LC assay. The outcome and sensitivity for serum and 24-h urine assays are convergent. Due to much more reliable and convenient sampling, we recommend serum instead of 24-h urine 5HIAA for diagnosis and follow-up of NEN patients.Funding Information
- Helsinki University Hospital Research Funds (TYH2018223, TYH2019254)
- Finska Läkaresällskapet
This publication has 41 references indexed in Scilit:
- Comparison of 24-h and overnight samples of urinary 5-hydroxyindoleacetic acid in patients with intestinal neuroendocrine tumorsEndocrine Connections, 2013
- Characterization and classification of matrix effects in biological samples analysesJournal of Chromatography A, 2010
- Measurement of plasma 5-hydroxyindole acetic acid by liquid chromatography tandem mass spectrometry—Comparison with HPLC methodologyJournal of Chromatography B, 2010
- Urinary 5-HIAA measurement using automated on-line solid-phase extraction–high-performance liquid chromatography–tandem mass spectrometryJournal of Chromatography B, 2008
- Daily Cyclic Changes in the Urinary Excretion of 5-Hydroxyindoleacetic Acid in Patients with Carcinoid TumorsClinical Chemistry, 2004
- Simultaneous determination of the major acidic metabolites of catecholamines and serotonin in urine by liquid chromatography with electrochemical detection after a one-step sample clean-up on sephadex G-10; Influence of vanilla and banana ingestionJournal of Chromatography B: Biomedical Sciences and Applications, 1988
- Determination of nine catecholamine metabolites and 5-hydroxyindolacetic acid in urine by capillary gas chromatographyJournal of Chromatography A, 1983
- Determination of 5-hydroxyindole-3-acetic acid in urine by high performance liquid chromatographyAnalytical Chemistry, 1978
- A specific assay for urinary 5-hydroxyindole-3-acetic acid by gas chromatographyClinica Chimica Acta; International Journal of Clinical Chemistry, 1975
- Fluorimetric determination of 5-hydroxyindoleacetic acid in human urine and cerebrospinal fluidClinica Chimica Acta; International Journal of Clinical Chemistry, 1969