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中国临床研究:2024,37(4):580-584
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血浆嗜铬粒蛋白A水平对嗜铬细胞瘤的诊断价值
(山西医科大学第三医院 山西白求恩医院 山西医学科学院 同济山西医院泌尿外科,山西 太原 030032)
Diagnostic value of plasma chromogranin A levels for pheochromocytoma
(Department of Urology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, Shanxi 030032, China)
摘要
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投稿时间:2023-07-10   网络发布日期:2024-04-20
中文摘要: 目的 探讨血浆嗜铬粒蛋白A(CgA)和游离甲氧基肾上腺素(MNs)水平在嗜铬细胞瘤(PHEO)诊断中的作用。 方法 回顾性分析2021年1月至2023年1月在山西白求恩医院就诊的26例PHEO患者(PHEO组)和31例其他肾上腺肿瘤患者(非PHEO组)的临床资料。比较PHEO患者与非PHEO患者术前血浆CgA水平,比较PHEO患者术后与术前血浆CgA水平的变化。以受试者操作特征曲线(ROC曲线)分析血浆CgA和MNs水平及其联合对PHEO的诊断效能。 结果 PHEO组患者术前血浆CgA水平显著高于非PHEO组[(647.8±196.2)ng/mL vs(96.4±34.1)ng/mL,t=14.15,P<0.01]。与术前比较,PHEO组患者术后血浆CgA水平显著降低[(114.8±60.5)ng/mL vs (647.8±196.2)ng/mL,t=12.78,P<0.01]。ROC曲线分析结果显示,CgA、MNs对PHEO诊断的AUC分别为0.988、0.940, 截断值分别为183.1 ng/mL和超过参考区间上限的两倍,敏感度分别为100%、84.6%,特异度分别为87.1%、93.5%;二者联合的AUC最高,为0.994。 结论 血浆CgA水平对PHEO患者有较高的诊断价值,可作为血浆MNs诊断PHEO的补充指标,以提高诊断的准确性。
Abstract:Objective To investigate the role of plasma chromogranin A (CgA) and free metanephrines (MNs) levels in the diagnosis of pheochromocytoma (PHEO). Methods The clinical data of 26 patients with PHEO (PHEO group) and 31 patients with other adrenal tumors (non-PHEO group) admitted to Shanxi Bethune Hospital from January 2021 to January 2023 were analyzed retrospectively. The preoperative plasma CgA levels were compared between PHEO patients and non-PHEO patients, and the changes of plasma CgA levels of PHEO patients were compared between postoperative and preoperative. The receiver operating characteristic curve (ROC curve) was used to analyze the diagnostic efficacy of the plasma CgA,MNs levels and their combination on PHEO. Results Preoperative plasma CgA level of patients in the PHEO group was significantly higher than that in the non-PHEO group [(647.8±196.2) ng/mL vs (96.4±34.1) ng/mL, t=14.15, P<0.01]. Compared to the preoperative level, the postoperative plasma CgA in the PHEO group was significantly reduced [(114.8±60.5) ng/mL vs (647.8±196.2) ng/mL, t=12.78, P<0.01]. ROC curve analysis results showed that the AUC of CgA and MNs for the diagnosis of PHEO were 0.988 and 0.940, and the cutoff values were 183.1 ng/mL and twice the upper limit of the reference interval,respectively,with sensitivity of 100% and 84.6%, and specificity of 87.1% and 93.5%, respectively; the combined AUC of the two was the highest, at 0.994. Conclusion Plasma CgA levels have a high diagnostic value in patients with PHEO,and can be used as a complementary indicator of plasma MNs for the diagnosis of PHEO to improve diagnostic accuracy.
文章编号:     中图分类号:R699.3    文献标志码:A
基金项目:山西省重点研发项目(202203021211072)
引用文本:
崔浩,秦梧耀,王晋垚,尚吉文.血浆嗜铬粒蛋白A水平对嗜铬细胞瘤的诊断价值[J].中国临床研究,2024,37(4):580-584.

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