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Diagnostic Accuracy of Salivary Metanephrines in Pheochromocytomas and Paragangliomas.
Eijkelenkamp, Karin; Osinga, Thamara E; van Faassen, Martijn; Kema, Ido P; Kerstens, Michiel N; Pacak, Karel; Sluiter, Wim J; Links, Thera P; van der Horst-Schrivers, Anouk N A.
Afiliación
  • Eijkelenkamp K; Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Osinga TE; Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • van Faassen M; Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Kema IP; Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Kerstens MN; Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Pacak K; Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
  • Sluiter WJ; Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Links TP; Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • van der Horst-Schrivers ANA; Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Clin Chem ; 67(8): 1090-1097, 2021 08 05.
Article en En | MEDLINE | ID: mdl-34096581
BACKGROUND: Measurements of plasma free metanephrines are recommended for diagnosing pheochromocytomas and paragangliomas (PPGL). Metanephrines can be detected in saliva with LC-MS/MS with sufficient analytical sensitivity and precision. Because collecting saliva is noninvasive and less cumbersome than plasma or urine sampling, we assessed the diagnostic accuracy of salivary metanephrines in diagnosing PPGL. METHODS: This 2-center study included 118 healthy participants (44 men; mean age: 33 years (range: 19--74 years)), 44 patients with PPGL, and 54 patients suspected of PPGL. Metanephrines were quantified in plasma and saliva using LC-MS/MS. Diagnostic accuracy; correlation between plasma and salivary metanephrines; and potential factors influencing salivary metanephrines, including age, sex, and posture during sampling, were assessed. RESULTS: Salivary metanephrines were significantly higher in patients with PPGL compared with healthy participants (metanephrine (MN): 0.19 vs 0.09 nmol/L, P < 0.001; normetanephrine (NMN): 2.90 vs 0.49 nmol/L, P < 0.001). The diagnostic sensitivity and specificity of salivary metanephrines were 89% and 87%, respectively. Diagnostic accuracy of salivary metanephrines was 88%, with an area under the ROC curve of 0.880. We found a significant correlation between plasma and salivary metanephrines (Pearson correlation coefficient: MN, 0.86, P < 0.001; NMN, 0.83, P < 0.001). Salivary NMN concentrations were higher when collected in a seated position compared with supine (P < 0.001) and increased with age (P < 0.001). CONCLUSIONS: Salivary metanephrines are a promising tool in the biochemical diagnosis of PPGL. Salivary metanephrines correlate with plasma free metanephrines and are increased in patients with PPGL. At this time, however, salivary metanephrines cannot replace measurement of plasma free metanephrines.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Paraganglioma / Feocromocitoma / Neoplasias de las Glándulas Suprarrenales Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Adult / Humans / Male Idioma: En Revista: Clin Chem Asunto de la revista: QUIMICA CLINICA Año: 2021 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Paraganglioma / Feocromocitoma / Neoplasias de las Glándulas Suprarrenales Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Adult / Humans / Male Idioma: En Revista: Clin Chem Asunto de la revista: QUIMICA CLINICA Año: 2021 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido