不同免疫分析系统检测甲状腺癌术后甲减患者甲状腺水平的一致性分析  

Consistency analysis of thyroid level in patients with hypothyroidism after thyroid carcinoma surgery detected by different immunoassay systems

作　　者：杜波 白雪梅 苏英 朱江 宋炳荣 赵永华 

机构地区：[1]榆林市中医医院检验科,陕西榆林719000 [2]榆林市中医医院肿瘤科,陕西榆林719000

出　　处：《热带医学杂志》2017年第11期1461-1464,共4页Journal of Tropical Medicine

摘　　要：目的分析不同免疫分析系统检测甲状腺癌术后甲减患者甲状腺水平的一致性。方法选择48例分化型甲状腺癌术后并发甲减患者,分别应用直接化学发光免疫系统与电化学发光免疫系统对入选患者的血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺球蛋白抗体(TGA)、抗甲状腺过氧化物酶抗体(TPO)水平进行检测。记录两种检测系统的各项甲状腺功能指标的检测结果,分析两种检测系统各项指标检测结果的一致性及TSH检测结果的相对偏差。结果两种检测系统所得血清T3、FT4水平均低于各自检测方法的正常下限值,血清T4、TSH、TGA与TPO水平均高于各自检测方法的上限值,FT3均处于正常参考范围。两种免疫检测系统的T3、T4、FT4、TSH、TGA、TPO检测结果均有良好一致性(Kappa=0.687,0.829,0.829,0.940,0.687,0.829),FT3检测结果的一致性较差(Kappa=0.266)。两种免疫分析系统所得TSH检测值在0.50μIU/m L、13.00μIU/m L处的相对偏差分别为17.53%和0.82%,均在20%以内,证实对血清TSH检测结果的一致性较佳。结论直接化学发光与电化学发光法对甲状腺癌术后甲减患者甲状腺水平的检测具有较高一致性,二者的相对偏差对甲减辅助诊断结果影响甚微,均可作为甲状腺功能的有效检测手段。Objective To analyze the consistency of thyroid levels in patients with thyroid cancer who underwent hypothyroidism by different immunoassay systems. Methods 48 patients with differentiated hypothyroidism after thyroid carcinoma surgery were selected. The serum levels of triodothyronine（T3）,tetraiodothyronine（T4）,free triiodothyronine （FT3）,free thyroxine（FT4）,thyroid stimulating hormone（TSH）,thyroglobulin antibody（TGA）,anti-thyroid peroxidase antibody（TPO） of patients were detected by direct chemiluminescence immune system and electrochemiluminescence immune system. The consistency of the results by two detection systems and the relative deviation of TSH detection results were analyzed. Results The serum levels of T4,TSH,TGA and TPO were higher than the upper limit of the respective detection methods,and FT3 was in the normal reference range. The serum levels of T3 and FT4 in two detection systems were lower than the normal lower limit of the respective detection methods,and the serum level of FT3 were all in the normal reference range. The results of T3,T4,FT4,TSH,TGA and TPO in the two immunoassay systems were well consistent（Kappa=0.687,0.829,0.829,0.940,0.687,0.829）,and the FT3 test results were less consistent（Kappa=0.266）. The relative deviation of the TSH values obtained from the two immunoassay systems were 17.53% and 0.82% at 0.50 μIU/mL and 13.00 μIU/mL, respectively,which was less than 20%,and the TSH test results were consistent. Conclusion Direct chemiluminescence immune system and electrochemiluminescence immune system had a high degree of consistency in the detection of thyroid levels in patients with thyroid cancer after operation. The relative deviation between two systems has little effect on diagnosis of hypothyroidism and can be used as an effective means for thyroid function.

关 键 词：甲状腺癌 甲减 免疫分析系统 甲状腺水平 

分 类 号：R736[医药卫生—肿瘤]