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Single-centre study of the diagnostic performance of plasma metanephrines with seated sampling for the diagnosis of phaeochromocytoma/paraganglioma

Lookup NU author(s): Dr Sarah Johnson, Dr Stephen Ball

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Abstract

© 2016, © The Author(s) 2016. Background: Measurement of plasma metanephrines is regarded as one of the best screening tests for phaeochromocytoma/paraganglioma. Current guidelines recommend that samples are ideally collected in the supine position after 30 min rest and interpreted using supine reference ranges, in order to optimize the diagnostic performance of the test. Current practice in our centre is to collect samples for plasma metanephrines from seated patients. The aim of the study was to determine, if seated sampling for plasma metanephrines provides acceptable diagnostic performance in our centre. Methods: Clinical and laboratory data of 113 patients, gathered over a four-year period 2010–2014, were reviewed. All had undergone preoperative plasma metanephrines measurement and had postoperative histopathology confirmation or exclusion of phaeochromocytoma/paraganglioma. Results: Of 113 patients included in the study, 40 had a histological diagnosis of phaeochromocytoma/paraganglioma. The remaining 73 patients had an alternative adrenal pathology. The diagnostic sensitivity of normetanephrine or metanephrine above the upper limit of our in-house seated reference range was 93%. However, excluding three cases of paraganglioma determined clinically and biochemically to be non-functional raised the sensitivity to 100%. Diagnostic specificity was 90%. Applying published supine reference ranges made no difference to diagnostic sensitivity in this group of patients but decreased diagnostic specificity to 75%. Conclusions: While these data are derived from a relatively small study population, they demonstrate acceptable diagnostic performance for seated plasma metanephrines as a screening test for phaeochromocytoma/paraganglioma. These data highlight a high diagnostic sensitivity for plasma metanephrines with seated sampling in our centre.


Publication metadata

Author(s): Boot C, Toole B, Johnson SJ, Ball S, Neely D

Publication type: Article

Publication status: Published

Journal: Annals of Clinical Biochemistry

Year: 2017

Volume: 54

Issue: 1

Pages: 143-148

Print publication date: 01/01/2017

Online publication date: 11/05/2016

Acceptance date: 02/04/2016

ISSN (print): 0004-5632

ISSN (electronic): 1758-1001

Publisher: Sage Publications Ltd

URL: https://doi.org/10.1177/0004563216650463

DOI: 10.1177/0004563216650463

PubMed id: 27170024


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