Plasmatic and Urinary 5-Hydroxyindolacetic Acid Measurements in Patients With Midgut Neuroendocrine Tumors: A GTE Study.
J Clin Endocrinol Metab
; 106(4): e1673-e1682, 2021 03 25.
Article
en En
| MEDLINE
| ID: mdl-33382891
ABSTRACT
CONTEXT Although 24-hour urinary 5-hydroxyindolacetic acid (24u5HIAA) is a key biomarker in midgut neuroendocrine tumors (NETs), it may be inaccurate and inconvenient. OBJECTIVE:
We compared the diagnostic performances of 24u5HIAA, overnight urinary 5HIAA (Ou5HIAA), and plasmatic 5HIAA (p5HIAA) in midgut NETs.METHODS:
This prospective, multicenter study included 80 patients with metastatic midgut NETs and 17 control patients with irritable bowel syndrome. 24u5HIAA, Ou5HIAA, and p5HIAA were measured in urine and plasma collected on 2 consecutive days following a specific recommended diet. Reproducibility of the biomarkers was evaluated by the Spearman test. Diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUROC). Correlations with the main clinical features and declared observance to the specific diet were assessed using AUROC and logistic regression models.RESULTS:
The reproducibility of 24u5HIAA, Ou5HIAA, and p5HIAA were excellent (ρâ =â 0.916; 0.897; 0.978, respectively, Pâ <â .001) with significant discrimination between patients and controls (AUROCâ =â 0.795, Pâ <â .001; 0.757, Pâ =â .001; 0.717, Pâ =â .005, respectively). All 3 markers were correlated with the presence of carcinoid syndrome (AUROCâ =â 0.702, Pâ =â .006; 0.701, Pâ =â .006; 0.697, Pâ =â .007, respectively), carcinoid heart disease (AUROCâ =â 0.896; 0.887; 0.923, Pâ <â .001, respectively, Pâ <â .001), and liver metastatic involvement greater than 30% (AUROCâ =â 0.827; 0.807; 0.849, Pâ <â .001, respectively, Pâ <â .001), independent from other traditional prognostic factors. Biomarker levels were similar between patients with optimal or suboptimal diet observance.CONCLUSION:
Ou5HIAA and p5HIAA could be used as more convenient alternatives to 24u5HIAA in patients with metastatic midgut NETs. Prospective long-term studies with repeated dosages are needed.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Tumores Neuroendocrinos
/
Neoplasias Gastrointestinales
/
Ácido Hidroxiindolacético
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Clin Endocrinol Metab
Año:
2021
Tipo del documento:
Article
País de afiliación:
Francia