Evaluation of an enzyme immunoassay for plasma-free metanephrines in the diagnosis of catecholamine-secreting tumors

Procopiou, Michel; Finney, Hazel; Akker, Scott; Chew, Shern L.; Drake, William M; Burrin, Jacky M.; Grossman, Ashley

doi:10.1530/eje-09-0172e

Cited by 7 publications

(11 citation statements)

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“…Also, it should be noted that negative test result for PFMs provides a high probability of excluding pheochromocytoma due to its high sensitivity. In agreement with previous reports [1][2][3][4][5][6][7], our present finding confirmed high sensitivity (0.957). We would like to confirm these clinical utility in the near future.…”

Section: Sensitivity and Specificity (Diagnostic Accuracy)supporting

confidence: 94%

“…In addition, the current result demonstrated good sensitivity (0.957) and specificity (0.973) for the measurement of PFMs. These are similar to the values reported in the literature for both sensitivity and specificity [1][2][3][4].…”

Section: Declaration Of Interestsupporting

confidence: 90%

“…Regarding each fraction of the PFMs, the AUC for pMet was lower than that reported in previous studies [4]. This is because pheochromocytomas secreting adrenaline account for a small portion of cases among Japanese pheochromocytoma patients.…”

Section: Declaration Of Interestcontrasting

confidence: 72%

“…chromocytoma, in addition to the use of clinical examinations, it is necessary to assess the secretory capacity of the tumor, including measuring catecholamine secretion based on the levels of direct secretory products of the adrenomedullary-sympathetic system in the plasma, urine or both. As this step is fraught with difficulties, measuring the levels of plasma free metanephrines (PFMs; fractionated measurement of both plasma free metanephrine and normetanephrine) is currently recognized to be the best biomarker for diagnosing pheochromocytoma in the United States and Europe especially due to its high sensitivity and fast and simple sample preparation [1][2][3][4][5][6][7]. However, these tests have not yet been evaluated in Japan due to the small amount of patients in each facility.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the available tests for a relatively accurate diagnosis in Japan include a combination of different tests: measurements of 24-hour urinary catecholamines, metanephrines and VMA in addition to measurement of the plasma concentrations of catecholamines. On the other hand, many previous studies, conducted outside of Japan, have reported the high performance and utility of measuring the levels of PFMs for the diagnosis of pheochromocytoma as an alternative to the standard methods [1][2][3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

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Plasma free metanephrines in the diagnosis of pheochromocytoma: diagnostic accuracy and strategies for Japanese patients

Tanaka

Isobe

et al. 2014

Endocr J

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abstract. Measuring the levels of the plasma free metanephrines (PFMs) represents a recently developed and promising test for the diagnosis of pheochromocytoma in the United States and Europe. As this test has not yet been evaluated in Japan, it is necessary to evaluate the diagnostic efficacy of measuring the levels of PFMs compared with the standard measurement of the urinary excretion of metanephrines (uMNs) whose reliability is well established to detect of pheochromocytoma. A total of 101 Japanese subjects clinically suspected of having pheochromocytoma in were included in this study. Subsequently, we prospectively measured the PFMs levels in all patients, compared with those of biochemical markers of the catecholamine secretion and metabolisms in the plasma and urine. All subjects with adrenal tumors underwent tumor excision. Data were available for 84 of the 101 patients, 47 of whom had histopathologically proven pheochromocytoma and 37 were finally diagnosed with non-pheochromocytoma. The results of comparisons in the accuracy of measurement for diagnosis of pheochromocytoma between PFMs and the urinary excretion of metanephrines (uMNs) were 0.980 VS 0.951 for AUC of receiver operatorating characteristic (ROC) curve, 0.957 VS 0.894 for sensitivity, and 0.973 VS 0.946 for specificity, respectively. Although the differences were small, the results of our study definitely demonstrated that measurement of PFMs was not inferior to standard urinary metanephrines (uMNs) measurement, which is established to be the most reliable biochemical method to detect pheochromocytoma. This study clearly shows measuring the PFMs levels to be a reliable and efficient method for diagnosing pheochromocytoma in Japanese patients, as demonstrated in previous reports.

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Section: Sensitivity and Specificity (Diagnostic Accuracy)supporting

confidence: 94%

Section: Declaration Of Interestsupporting

confidence: 90%

Section: Declaration Of Interestcontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Plasma free metanephrines in the diagnosis of pheochromocytoma: diagnostic accuracy and strategies for Japanese patients

Tanaka

Isobe

et al. 2014

Endocr J

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Cardiac Drug Therapy

Khan

2015

Contemporary Cardiology

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Plasma and Urinary Metanephrines Determined by an Enzyme Immunoassay, but not Serum Chromogranin A for the Diagnosis of Pheochromocytoma in Patients with Adrenal Mass

Unger

Hinrichs

Deutschbein

et al. 2012

Exp Clin Endocrinol Diabetes

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Adrenal pheochromocytomas are neoplasms characterized by catecholamine excess. Determination of metanephrines by high-pressure liquid chromatography has been well established for the diagnosis of pheochromocytomas, demonstrating high sensitivity and specificity. This study evaluates the diagnostic value of newly available enzyme immunoassays for metanephrines in plasma and urine. Chromogranin A was studied as a potential additional diagnostic tool. Spontaneous blood samples and 24-h urine samples were collected in 149 subjects, including 24 histologically proven pheochromocytomas, 17 aldosterone-secreting and 21 cortisol-secreting adrenal adenomas, 30 nonfunctioning adrenal masses, 15 patients with essential hypertension and 42 healthy normotensive volunteers. Plasma and urinary metanephrine and normetanephrine as well as chromogranin A were determined and putative thresholds were calculated by ROC analysis. Plasma free normetanephrine was found to be the best single parameter with the highest sensitivity (89.5%) and speciﬁcity (98.3%) using a threshold of 167 pg/ml. Analysis of the combination of plasma free metanephrines revealed a similar sensitivity with lower specificity of 90.0%. Considering both urinary parameters demonstrated a slightly higher sensitivity (92.9%) with lower specificity (77.6%). ROC analysis revealed a threshold of 215 µg/l for chromogranin A with rather low sensitivity (73.9%) and specificity (74.2%). A weak positive correlation was found between the tumor size of pheochromocytomas and plasma metanephrine (r = 0.53, p ≤ 0.05) as well as chromogranin A (r = 0.60, p ≤ 0.01). In conclusion, plasma free and urinary metanephrines measured by enzyme immunoassays are convenient and reliable parameters for the diagnosis of pheochromocytoma. In contrast, CgA demonstrated poor sensitivity and specificity.

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Evaluation of an enzyme immunoassay for plasma-free metanephrines in the diagnosis of catecholamine-secreting tumors

Abstract: The authors and journal apologize for the error in the above paper which appeared in 161 (1) 131–140. The kits for the assay of free metanephrines were supplied by both Immunodiagnostic Systems Ltd (IDS), Tyne and Wear, UK and also Biotech-IgG (UK) Ltd, Wilmslow, UK.

Cited by 7 publications

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Plasma free metanephrines in the diagnosis of pheochromocytoma: diagnostic accuracy and strategies for Japanese patients

Plasma free metanephrines in the diagnosis of pheochromocytoma: diagnostic accuracy and strategies for Japanese patients

Cardiac Drug Therapy

Plasma and Urinary Metanephrines Determined by an Enzyme Immunoassay, but not Serum Chromogranin A for the Diagnosis of Pheochromocytoma in Patients with Adrenal Mass

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