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pISSN 2950-9114 eISSN 2950-9122
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Lab Med Qual Assur 2023; 45(1): 34-41

Published online March 31, 2023


Copyright © Korean Association of External Quality Assessment Service.

The Stability Evaluation of Plasma and Urine Metanephrines for Diagnosing Pheochromocytoma and Paraganglioma by LC-MS/MS

Go Eun Bae * , Jaewan Jung * , and Soo-Youn Lee

Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence to:Soo-Youn Lee
Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
Tel +82-2-3410-1834
E-mail suddenbz@skku.edu
*These authors contributed equally to this work and shared the first authorship.

Received: October 18, 2022; Revised: November 30, 2022; Accepted: December 12, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


The measurement of metanephrine (MN) and normetanephrine (NMN) in plasma and urine using liquid chromatography-tandem mass spectrometry (LC-MS/MS) is the gold standard for the initial biochemical testing for pheochromocytomas and paragangliomas (PPGLs). Despite their high diagnostic value, there is a lack of consensus on the stability of MN and NMN in clinical specimens. This study aimed to analyze the stability of MN and NMN in both plasma and urine using LC-MS/MS under various conditions. Plasma and urine samples were prepared by spiking them with standard materials of MN and NMN. The samples were pretreated under solid phase extraction and analyzed using the LC-MS/MS system (Agilent Technologies, USA). In both plasma and urine specimens, MN and NMN were stable under the following conditions: (1) room temperature for 24 hours, (2) 4℃ for 8 days, (3) –20℃ for 8 days, and (4) –80℃ for 7 months. MN and NMN were stable after at least three cycles of the freeze and thaw process, and stable for 7 days in a container with dry ice. In this study, we comprehensively evaluated the stability of MN and NMN in plasma and urine and made recommendations to improve specimen handling to ensure reliable testing for PPGLs.

Keywords: Metanephrine, Normetanephrine, Plasma, Urine, Mass spectrometry, Pheochromocytoma, Paraganglioma, Stability

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