Observations on the Biochemical Diagnosis of Neuroblastoma

Abstract

During the past 4 years intensive work by many investigators has shown the variety of catecholamines and their metabolites which may be excreted in the urine of patients suffering from neuroblastoma. This work was reviewed up to 1962 at the Manchester Symposium (Bell [1]) and major additions since have included VON Studnitz, Käser and Sjoerdsma [2] and Gjessing [3]. As with many clinical biochemical problems there are two main lines of approach, one leading towards easier diagnosis using simple techniques aimed at major metabolites, the other towards a better understanding of the underlying biochemical abnormality by estimating as many of the metabolites as possible. It is hoped that both may lead to earlier and more specific diagnosis with increased possibility of cure but the emphasis of ones work tends to be towards one extreme or the other. In my case it is towards simpler diagnosis and first I will outline two simple methods which were suggested for this purpose in 1961 (Bell and Steward [4]) then illustrate a possible grouping of cases according to their excretion pattern.