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

摘要:

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。

Abstract:

Objective：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 progno－sis of pheochromocytoma.