Diagnostic accuracy of free and total metanephrines in plasma and fractionated metanephrines in urine of patients with pheochromocytoma.

Details

Serval ID
serval:BIB_2BF86A335F41
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Diagnostic accuracy of free and total metanephrines in plasma and fractionated metanephrines in urine of patients with pheochromocytoma.
Journal
European Journal of Endocrinology / European Federation of Endocrine Societies
Author(s)
Grouzmann E., Drouard-Troalen L., Baudin E., Plouin P.F., Muller B., Grand D., Buclin T.
ISSN
1479-683X[electronic], 0804-4643[linking]
Publication state
Published
Issued date
2010
Volume
162
Number
5
Pages
951-960
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Plasma free and urinary metanephrines are recognized biomarkers for the assessment of pheochromocytoma. Plasma total metanephrines with a long half-life may represent another useful biomarker. OBJECTIVE: The aim of this study is to evaluate the diagnostic performances of plasma total metanephrines alone or combined with free metanephrines and fractionated 24-h urinary metanephrines. METHODS: A retrospective, case-control diagnostic test study was conducted between 1999 and 2007 in two university hospitals in Switzerland and two institutions in France. The patients included 46 cases with histologically proven pheochromocytoma, and 181 controls suspected of tumor with negative investigations and 3-year follow-up. None had renal dysfunction. Sensitivity and specificity were compared after expressing each measurement result as a ratio over its upper reference limit, adding the ratios of normetanephrine and metanephrine, and defining cut-off values of 1 or 2 for this sum. RESULTS: Applying a cut-off value of 1, plasma free and total metanephrines and urinary fractionated metanephrines had similar sensitivities of 96% (95% confidence interval, 86-99%), 95% (85-99%), and 95% (84-99%) along with similar specificities of 89% (83-94%), 91% (84-95%), and 86% (80-91%). A cut-off of 2 for the sum of ratios over reference limit improves the specificity, and it can be used for a confirmation test based on another biomarker taken among the three biomarkers. CONCLUSION: All three metanephrine-based tests perform equivalently for diagnosing pheochromocytoma in the absence of renal insufficiency, and can be conveniently associated two by two for confirming/excluding tumor.
Keywords
Adolescent, Adrenal Gland Neoplasms/diagnosis, Adrenal Gland Neoplasms/urine, Adult, Aged, Aged, 80 and over, Child, Female, Humans, Male, Metanephrine/blood, Metanephrine/urine, Middle Aged, Normetanephrine/blood, Normetanephrine/urine, Pheochromocytoma/diagnosis, Pheochromocytoma/urine, Retrospective Studies, Sensitivity and Specificity, Tumor Markers, Biological/urine
Pubmed
Web of science
Open Access
Yes
Create date
28/06/2010 16:56
Last modification date
20/08/2019 13:11
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