NEUROBLASTOMA SCREENING IN ASYMPTOMATIC CHILDREN

NEUROBLASTOMA IS THE MOST COMMON, HIGHLY MALIGNANT, SOLID TUMOR FOUND IN CHILDREN. WHEN DIAGNOSED IN ASYMPTOMATIC CHILDREN, THE PROGNOSIS IS OFTEN POOR. HOWEVER, WHEN DETECTED IN ASYMPTOMATIC CHILDREN AS A RESULT OF THE URINE TUMOR MARKERS SCREENING PROGRAM, THE NEUROBLASTOMA IS USUALLY LOCALIZED AND TREATABLE, AND THE OUTCOME IS FAVORABLE. MOST NEUROBLASTOMA CASES HAVE HIGH URINE LEVELS OF HOMOVANILLIC ACID (HVA) AND/OR VANILLYLMANDELIC ACID (VMA). THESE TWO TUMOR MARKERS CAN BE MEASURED ACCURATELY AND PRECISELY BY HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY OR GAS CHROMATOGRAPHY, BUT THESE PROCEDURES ARE NOT PRACTICAL FOR DETERMINING HVA AND VMA IN LARGE NUMBERS OF URINE SPECIMENS. THIS PROJECT WILL DEVELOP A UNIQUE ENZYME IMMUNOASSAY (EIA) METHOD WITH MONOCLONAL ANTIBODIES TO DETECT HVA AND VMA. THE TECHNIQUE WILL BE AUTOMATED, COMPUTERIZED, AND COST EFFECTIVE, PERMITTING THE SCREENING OF A LARGE NUMBER OF SPECIMENS. THE EIA METHOD FOR HVA AND VMA WILL BE SPECIFIC AND SENSITIVE ENOUGH TO DETECT MANY NEUROBLASTOMA CASES IN THE EARLY ASYMPTOMATIC STAGES, WHEN THE DISEASE IS TREATABLE AND LIVES CAN BE SAVED.