Analytical validation and clinical application of urinary vanillylmandelic acid and homovanillic acid by LC-MS/MS for diagnosis of neuroblastoma

Biomed Chromatogr. 2019 Jun;33(6):e4484. doi: 10.1002/bmc.4484. Epub 2019 Feb 7.

Abstract

Vanillylmandelic acid (VMA) and homovanillic acid (HVA) are clinical biomarkers for diagnosis of neuroblastoma (NB), which commonly occurs in the childhood. Development and application of a robust LC-MS/MS method for fast determination of these biomarkers for optimal laboratory testing of NB is essential in clinical laboratories. In present study, we developed and validated a simple liquid chromatography tandem mass spectrometry (LC-MS/MS) method for quick clinical testing of VMA and HVA for diagnosis of NB. The method was validated according to the current CLSI C62-A and FDA guidelines. The age-adjusted pediatric reference intervals and diagnostic performance were evaluated in both 24 h urine and random urine. Injection-to-injection time was 3.5 min. Inter- and intra-assay coefficients of variation (CVs) were ≤3.88%. The lower limit of quantification and the limit of detection were 0.50 and 0.25 μmol/L for both VMA and HVA. Recoveries of VMA and HVA were in the ranges of 85-109% and 86-100% with CVs ≤5.76%. This method was free from significant matrix effect, carryover and interference. The establishment of age-adjusted pediatric reference intervals by this LC-MS/MS method was favorable for the improvement in diagnostic performance, which was crucial for correct interpretation of test results from children in both 24 h and random urine.

Keywords: HVA; LC-MS/MS; VMA; neuroblastoma; urine.

MeSH terms

  • Adolescent
  • Biomarkers, Tumor / urine
  • Child
  • Child, Preschool
  • Chromatography, Liquid / methods*
  • Female
  • Homovanillic Acid / urine*
  • Humans
  • Infant
  • Infant, Newborn
  • Limit of Detection
  • Linear Models
  • Male
  • Neuroblastoma / diagnosis*
  • Neuroblastoma / urine
  • Reproducibility of Results
  • Tandem Mass Spectrometry / methods*
  • Vanilmandelic Acid / urine*

Substances

  • Biomarkers, Tumor
  • Vanilmandelic Acid
  • Homovanillic Acid