Radioimmunoassay of free plasma metanephrines for the diagnosis of catecholamine-producing tumors
-
Eric Pussard
,
Amel Chaouch
Abstract
Background: The determination of plasma metanephrines (MNs) provides a highly sensitive test for the diagnosis of catecholamine producing tumors. Chromatographic determinations with electrochemical or mass spectrometric detections are the methods of choice, but immunological assays have been developed. This study evaluated the clinical performances of a radioimmunoassay for free MNs in plasma.
Methods: MNs, normetanephrine (NMN) and metanephrine (MN) and catecholamines, norepinephrine (NE) and epinephrine (E) were determined in plasma and urine of 533 patients suspected of catecholamine producing tumor. Urinary and plasma catecholamines and urinary MNs were determined by HPLC using amperometric detection. Plasma MNs were purified by solid phase chromatography and quantified by a specific radioimmunoassay.
Results: Fifty-nine patients had tumors (13 paraganglioma and 46 pheochromocytoma) and the diagnosis was excluded in 474 patients. Receiver operator characteristic curves have identified optimal thresholds at 100 pg/mL for plasma NMN (sensitivity 96.6% and specificity 95.8%) and 70 pg/mL for plasma MN (sensitivity 61.0% and specificity 96.8%). These cut-off values were lower than those suggested by the manufacturer (170 and 100 pg/mL, respectively). The sensitivity of combined MNs was similar in plasma (100%) and urine (98%) but higher than that of urinary catecholamines (85%, p<0.001). The specificity of combined MNs in plasma (95%) was higher than urinary MNs (85%, p<0.001) and plasma catecholamines (75%, p<0.001).
Conclusions: Plasma-free and urinary-total MNs have a better discriminative power than catecholamines in the diagnosis of catecholamines producing tumors. Using these established cut-offs, measurement of plasma-free MN by radioimmunoassay represents an effective alternative to chromatographic methods.
The authors are grateful to Claudine Rouillard, Michel Neveux and Nelly Guigueno for expert technical assistance.
Conflict of interest statement
Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
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©2014 by Walter de Gruyter Berlin Boston
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Articles in the same Issue
- Masthead
- Masthead
- Editorial
- Point of care testing: evolving scenarios and innovative perspectives
- Review
- Point-of-care testing: where is the evidence? A systematic survey
- Mini Review
- Vulnerability of point-of-care test reagents and instruments to environmental stresses: implications for health professionals and developers
- Opinion Paper
- Twenty-five years of idiopathic calcium nephrolithiasis: has anything changed?
- Genetics and Molecular Diagnostics
- Optimizing the purification and analysis of miRNAs from urinary exosomes
- General Clinical Chemistry and Laboratory Medicine
- Extensive study of human insulin immunoassays: promises and pitfalls for insulin analogue detection and quantification
- Absorptive chemistry based extraction for LC-MS/MS analysis of small molecule analytes from biological fluids – an application for 25-hydroxyvitamin D
- Evaluation of 3-epi-25-hydroxyvitamin D3 cross-reactivity in the Roche Elecsys Vitamin D Total protein binding assay
- Quantification of linezolid in serum by LC-MS/MS using semi-automated sample preparation and isotope dilution internal standardization
- Comparison of two immunoassays for measurement of faecal calprotectin in detection of inflammatory bowel disease: (pre)-analytical and diagnostic performance characteristics
- Reference Values and Biological Variations
- Reference change values to assess changes in concentrations of biomarkers of exposure in individuals participating in a cigarette-switching study
- Reference values of fetal serum β2-microglobulin in the Chinese: evaluation of its clinical usefulness
- Cancer Diagnostics
- Gut neuroendocrine tumor blood qPCR fingerprint assay: characteristics and reproducibility
- Androgen deprivation decreases prostate specific antigen in the absence of tumor: implications for interpretation of PSA results
- Radioimmunoassay of free plasma metanephrines for the diagnosis of catecholamine-producing tumors
- Infectious Diseases
- Plasma endothelial cell-specific molecule-1 (ESM-1) in management of community-acquired pneumonia
- A soluble form of the macrophage-related mannose receptor (MR/CD206) is present in human serum and elevated in critical illness
- Letters to the Editor
- Evaluation of a JAK2 V617F quantitative PCR to monitor residual disease post-allogeneic hematopoietic stem cell transplantation for myeloproliferative neoplasms
- Is magnetic resonance imaging really innocent?
- Clinical sample stability and measurement uncertainty
- A specific and sensitive activated partial thromboplastin time (APTT)-based factor VIII inhibitor screening assay
- Evaluating the inappropriateness of repeated laboratory testing in a teaching hospital of South Italy
- Could kidney glomerular filtration impairment represent the “Achilles heel” of HE4 serum marker? A possible further implication
