HPLC-ED检测血浆游离型甲氧基肾上腺素类物质诊断嗜铬细胞瘤及预后观察

Plasma free metanephrines measured by HPLC-ED in the diagnosis of pheochromocytoma and prognosis observation

目的:探讨高效液相色谱-电化学法(high performance liquid chromatography-electrochemical detection,HPLC-ED)检测血浆游离型甲氧基肾上腺素类物质(metanephrines,MNs)在嗜铬细胞瘤中诊断应用和预后观察。方法:采用HPLC-ED检测分析血浆游离型MNs嗜铬细胞瘤患者21例、健康对照组26例、原发性高血压组23例和非嗜铬细胞瘤性肾上腺占位性疾病组24例。结果:嗜铬细胞瘤患者血浆游离型MNs浓度明显高于其他3组(P<0.05);以甲氧基去甲肾上腺素(normetanephrine,NMN)150 ng/L和(或)甲氧基肾上腺素(metanephrine,MN)120 ng/L为切点,诊断敏感度、特异性分别为100%、89%。NMN、MN浓度与肿瘤体积密切相关(NMN:r=0.952,P=0.000;MN:r=0.510,P=0.018)。嗜铬细胞瘤患者在肿瘤切除后血MNs浓度迅速降低。结论:血浆游离型MNs是诊断嗜铬细胞瘤和预后观察的良好标志物。

Objectlve：To investigate the clinical significance of plasma free metanephrines（MNs） in the diagnosis and prognosis of pheochromocytoma by high performance liquid chromatography-electrochemical detection （HPLC-ED）. Methods：HPLC-ED was carried out to detect plasma free MNs,including 21 patients with pheochromocytoma, 26 healthy volunteers, 23 patients with primary hypertension and 24 patients with adrenal mass but without pheochromocytoma. Results ： Plasma concentrations of free MNs in patients with pheochromocytoma were significantly increased compared with those of other groups （P〈0.05）. Taking normetanephrine （NMN） 150 ng/L and（or） metanephrine（MN） 120 ng/L as cut-off value,the sensitivity and specificity for diagnosis of pheochromocytoma were 100% and 89% respectively. Plasma concentrations of free MNs showed significant positive relationships with tumors size in patients with pheochromocytomas （NMN： r=0.952, P=0.000; MN： r=0.510, P=0.018）. Plasma concentrations of free MNs in patients with pheochromocytoma dropped rapidly after the surgery. Conclusion：Plasma free MNs are good markers for the diagnosis and prognosis of pheochromocytoma.