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Related Experiment Videos

False positive results in a neuroblastoma screening programme

S Bell1, L Parker, A W Craft

  • 1Department of Child Health, Medical School, University of Newcastle Upon Tyne, England.

Medical and Pediatric Oncology
|January 1, 1994
PubMed
Summary

This study screened 20,829 infants for neuroblastoma using urine homovanillic (HVA) and vanillylmandelic (VMA) acid levels. New centiles significantly reduced false positives, improving early detection accuracy.

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Area of Science:

  • Pediatric Oncology
  • Biochemical Screening
  • Diagnostic Biomarkers

Background:

  • Neuroblastoma screening in infants is crucial for early detection.
  • Urinary homovanillic acid (HVA) and vanillylmandelic acid (VMA) are established biomarkers.
  • Improving screening accuracy requires optimizing detection thresholds.

Purpose of the Study:

  • To evaluate the effectiveness of a new screening method for neuroblastoma in infants.
  • To assess the diagnostic accuracy of urinary HVA and VMA levels in a large infant cohort.
  • To determine the impact of revised centiles on false positive and negative rates.

Main Methods:

  • Screening of 20,829 infants at 6 months of age.
  • Measurement of urinary homovanillic acid (HVA) and vanillylmandelic acid (VMA) levels, rationed to creatinine.

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  • Application of a threshold (mean + 3 SD) and revised centiles for positivity determination.

    • Main Results:

    • Two cases of neuroblastoma were confirmed among 10 infants with elevated HVA/VMA levels.
    • Revised centiles reduced the false positive rate from a higher initial value to 0.01% (3 out of 8 false positives).
    • The false negative rate remained unchanged, indicating maintained sensitivity.

    Conclusions:

    • Revised centiles for urinary HVA and VMA significantly enhance the specificity of neuroblastoma screening in infants.
    • This improved screening method offers a more accurate approach to identifying infants requiring further investigation for neuroblastoma.
    • The study highlights the importance of refining biochemical marker thresholds for effective pediatric cancer screening.