1General Surgery Department, James Cook University Hospital, England.
2Medical School, Misr University for Science and Technology, College of Medicine, Egypt.
Endocr Regul. 2023 Sep 16;57(1):183-190. doi: 10.2478/enr-2023-0022. Print 2023 Jan 1.
Pheochromocytomas (PHEO) and paraganglioma (PGLs) are rare neuroendocrine catecholamine-producing tumors that arise from the chromaffin cells of either the adrenal medulla or extra-adrenal paraganglionic tissues. Despite the recent advances in imaging technologies, biochemical evidence of excessive catecholamine production by the tumor is considered the most important test for the diagnosis of these tumors. The aim of the present study is to investigate the role of the catecholamine metabolites (normetanephrine and metanephrine) levels in the diagnosis of PHEO/PGLs and to evaluate if their levels correlate with the size of these tumors. Twenty-five patients were included in the study during the time period of 10 years. Their data were compared with another set of 25 patients to obtain the sensitivity and specificity of metanephrine and normetanephrine in the diagnosis of PHEO/PGLs. The tumor size was reviewed in every patient to obtain the correlation coefficient between the tumor sizes and the plasma/24-hour urinary metanephrine levels. The sensitivity and specificity rates for plasma metanephrine were 80-92% and 92-96%, respectively; while for 24-hour urinary metanephrine were 80-90% and 95-100%, respectively. We found a strong positive relationship between the tumor size and the plasma levels of normetanephrine (r=0.518, p<0.01), and metanephrine (r=0.577, p<0.01). While the relation with the 24-hour urinary concentrations of normetanephrine (r=0.384, p=0.01) and 24-h urinary meta-nephrine (r=0.138, p<0.01) was low. The determination of plasma and 24-hour urinary levels of metanephrines is a reliable test for the diagnosis of PHEO, as they are continuously produced by the tumor cells in contrast to catecholamines.
嗜铬细胞瘤（PHEO）和副神经节瘤（PGL）是罕见的神经内分泌儿茶酚胺产生肿瘤，源自肾上腺髓质或肾上腺外副神经节组织的嗜铬细胞。尽管成像技术最近取得了进展，但肿瘤过量儿茶酚胺产生的生化证据被认为是这些肿瘤诊断的最重要测试。本研究旨在探讨儿茶酚胺代谢物（去甲肾上腺素和间甲肾上腺素）水平在 PHEO/PGL 诊断中的作用，并评估其水平是否与这些肿瘤的大小相关。在 10 年的时间内，共有 25 名患者纳入本研究。将他们的数据与另一组 25 名患者进行比较，以获得去甲肾上腺素和间甲肾上腺素在 PHEO/PGL 诊断中的敏感性和特异性。对每位患者的肿瘤大小进行复查，以获得肿瘤大小与血浆/24 小时尿间甲肾上腺素水平之间的相关系数。血浆间甲肾上腺素的敏感性和特异性分别为 80-92%和 92-96%；而 24 小时尿间甲肾上腺素分别为 80-90%和 95-100%。我们发现肿瘤大小与血浆间甲肾上腺素水平之间存在很强的正相关关系（r=0.518，p<0.01）和间甲肾上腺素（r=0.577，p<0.01）。而与 24 小时尿间甲肾上腺素浓度的关系（r=0.384，p=0.01）和 24 小时尿间甲肾上腺素（r=0.138，p<0.01）则较低。血浆和 24 小时尿间甲肾上腺素水平的测定是 PHEO 诊断的可靠测试，因为它们与儿茶酚胺不同，是由肿瘤细胞持续产生的。
