放射免疫法血清甲状腺球蛋白检测对免疫分析法血清甲状腺球蛋白检测的辅助作用  

The Complementary Role of Radioimmunoassay for Immunometric Assay of Thyroglobin

作　　者：何健[1] 潘明志[2] 黄蕤[2] 唐恭顺[2] 

机构地区：[1]成都市第二人民医院核医学科,成都610017 [2]四川大学华西医院核医学科

出　　处：《华西医学》2014年第8期1479-1482,共4页West China Medical Journal

基　　金：国家自然科学基金(30970859)~~

摘　　要：目的比较免疫分析法（IMA）血清甲状腺球蛋白（Tg）值（Tg-IMA）、放射免疫法（RIA）血清Tg值（Tg-RIA）的一致性,评价Tg-RIA能否作为Tg-IMA补充标志物。方法收集四川大学华西医院2012年9月-12月55例分化型甲状腺癌（DTC）随访患者的血清,分别测定Tg-IMA、Tg-RIA。以出院诊断为标准评价Tg-IMA、Tg-RIA的价值。结果 55例DTC患者中,2例Tg-IMA假阴性被Tg-RIA校正,5例Tg-RIA假阴性考虑RIA试剂盒灵敏度不够,4例Tg-IMA低浓度阳性（1.07～4.09μg/L）需要随访。11例内源性甲状腺球蛋白抗体强阳性（〉115 kU/L）的DTC患者中,Tg-IMA仅2例阳性,Tg-RIA则9例阳性。2例Tg-IMA、Tg-RIA均阳性者及2例Tg-IMA阴性、Tg-RIA阳性者均诊断为DTC转移,给予碘131治疗或再次手术。结论 Tg-RIA可作为DTC随访的补充标志物发现Tg-IMA假阴性。Objective To evaluate whether thyroglobin（Tg） value by radioimmunoassay（Tg-RIA） can be used as a complementary marker in differentiated thyroid cancer（DTC） patients, as serum Tg value is the key marker for the follow-up of patients with DTC, and endogenous antithyroglobulin（TgAb） interferes with serum Tg value by immunometric assay（Tg-IMA）. Methods Fifty-five in-hospital patients with DTC after total thyroidectomy and 131 I ablation during September and December 2012 were enrolled. Tg-IMA tests and Tg-RIA tests were performed separately. Diagnostic criteria about relapse, metastasis or diseasefree status of thyroid carcinoma were established by serum Tg, diagnostic whole body scan（D-WBS）, neck ultrasonography, chest CT and patients＇ history. Results Two DTC patients showed false negative Tg-IMA and true positive Tg-RIA. Five patients had false negative Tg-RIA because of low sensitivity of RIA. Four patients with weak positive Tg-IMA（1.07-4.09 μg/L） required follow-up. Among the 11 DTC patients with strong TgAb positivity（〉 115 kU/L）, two patients with positive Tg-IMA and positive Tg-RIA received second operation or radioiodine therapy, seven patients had positive Tg-RIA and negative Tg-IMA. Five of the seven patients with strong positive TgAb needed further follow-up, and two of them received radioiodine therapy. Conclusion Tg value with radioimmunoassay is a complementary marker to find false negative Tg-IMA in follow-up patients with DTC.

关 键 词：甲状腺癌 甲状腺球蛋白 抗体 免疫分析法 放射免疫法 

分 类 号：R736.1[医药卫生—肿瘤]