Darwin Asa, Waters Corporation (Milford, MA, USA)

Joanne Adaway and Brian Keevil, University Hospital, South Manchester, UK

Plasma adrenergic hormones are commonly measured as diagnostic indications for a variety of neuroendocrine system tumors. More specifically, in patients with neural crest tissue or adrenal paraganglioma, the content of catecholamine hormones in norepinephrine is significantly increased. Elevated plasma levels of adrenergic hormones are often used to diagnose the presence or absence of a tumor and, in some cases, to diagnose the location of the tumor. Hypertension is usually one of the symptoms of neuroendocrine tumors. Therefore, many clinical laboratories use LC/MS technology to further confirm the presence of neuroendocrine tumors by screening hypertensive patients with high levels of plasma adrenergic hormones.

As early as many years ago, clinical laboratories have developed LC/MS methods for the determination of plasma adrenergic hormones for the diagnosis of a variety of neuroendocrine tumors. However, although LC/MS is capable of quantitatively detecting plasma adrenaline, effective sample preparation and detailed analysis of various adrenergic hormones has been difficult. In particular, metanephrine, such as 3-methoxytyramine (3-MT), has been shown to have problems with chromatographic separation methods, which may lead to an overestimation of the level of norepinephrine. In addition, many laboratories do not detect 3-MT because the sensitivity of the analytical methods used is not sufficient to measure low concentrations of analytes. However, accurate detection of 3-MT helps to further diagnose tumor type, location, and potential metastasis.

This study developed a method for simultaneous measurement of three plasma adrenergic hormones. This method uses LC/MS and an online SPE system. The combination of SPE sample preparation and LC/MS analysis makes the analysis of these important plasma adrenergic hormones more sensitive and efficient.

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