染细胞瘤的生物化学诊断:哪个测试是最好的?
Jacques W M Lenders1, Karel Pacak, McClellan M Walther
1Department of Internal Medicine, St Radboud University Medical Center, Geert Grooteplein Zuid 8, PO Box 9101, 6500 HB, Nijmegen, the Netherlands. j.lenders@aig.azn.nl
JAMA
|March 21, 2002
概括
血中自由的甲基内弗林是染细胞瘤的最佳诊断测试,具有卓越的灵敏度和特异性. 这项测试应该是诊断这种罕见瘤的首选.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 临床诊断 临床诊断 临床诊断
背景情况:
- 发红细胞瘤的诊断依赖于检测过多的catecholamine产量.
- 最佳的生物化学测试为染细胞瘤仍然未确定.
研究的目的:
- 为了确定最有效的生物化学测试或测试组合来诊断染细胞瘤.
主要方法:
- 一项多中心队列研究分析了来自214例确诊的乳红细胞瘤病例和644例对照病例的数据.
- 评估了各种等离子体和尿路甲基可胺和甲基氨酸测试的敏感性,特异性和预测值.
主要成果:
- 血中自由的甲基内弗林显示出对染细胞瘤诊断的最高灵敏度 (99%).
- 尿液中的瓦尼曼代尔酸和总甲氨酸显示出最高的特异性.
- 没有任何测试组合能提高诊断准确度,只能用血中自由的甲基内弗林.
结论:
- 由于其卓越的性能,血自由甲基内是诊断染细胞瘤的建议初始测试.
- 这种测试既有效排除,也有效确认染细胞瘤的存在.
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