尿甲氧基肾上腺素及甲氧基去甲肾上腺素在嗜铬细胞瘤诊断中的作用

Significance of Uric Normetanephrine and Metanephrine in Diagnosis of Pheochromocytoma

目的:测定尿液中甲氧基肾上腺素和甲氧基去甲肾上腺素,并评价其在嗜铬细胞瘤诊断中的作用。方法:选择酶联免疫分析法,对2014年1月至2015年1月广州军区广州总医院有嗜铬细胞瘤筛查指征的患者的24 h尿甲氧基肾上腺素和甲氧基去甲肾上腺素进行测定。结果:嗜铬细胞瘤患者24 h尿甲氧基肾上腺素和甲氧基去甲肾上腺素含量明显高于肾上腺皮质腺瘤、肾上腺增生、原发性醛固酮增多症等其他肾上腺占位性疾病患者,同时也显著高于原发性高血压患者及健康人参考区间上限值;以甲氧基去甲肾上腺素806.5μg或甲氧基肾上腺素385.5μg为切点,诊断嗜铬细胞瘤的敏感度为83.3%、特异性为90%;甲氧基去甲肾上腺素和甲氧基肾上腺素的受试者工作特征曲线下面积分别为0.912±0.057和0.886±0.076。结论:酶联免疫法检测24 h尿甲氧基去甲肾上腺素和甲氧基肾上腺素的方法准确度和特异性均较高,可以作为嗜铬细胞瘤的初步筛查、排除、临床诊断的可靠的实验室检查方法。

Objective： To analyze the content of uric normetanephrine（NMN） and metanephrine（MN）, and evalu-ate their significance in diagnosis of pheochromocytoma. Methods： From January 2014 to January 2015, the pa-tients charactered with pheochromocytoma screening indications were selected from Guangzhou Military Area Hospi-tal. The content of NMN and MN in 24 hours urine were detected by ELISA. Results： The level of NMN andMN in 24 h urine of pheochromocytoma patients were in evidence higher than those of the patients with other ad-renal masses or primary hypertension, they also had a marked difference comparing to the reference interval thresh-old of healthy people. The sensitivity and specificity for the diagnosis of pheochromocytoma were 83.3% and 90%respectively when the content of 24 h uric NMN was 806.5 μg and MN was 385.5 μg. The area under ROCcurve of NMN was 0.912±0.057, and that of MN was 0.886±0.076. Conclusion： Both sensitivity and specificity ofELISA method to detect 24 h uric NMN and MN are high and it can be adopted as a reliable method to screen,exclude, diagnose the pheochromocytoma.